Paediatric and perinatal epidemiology最新文献

{"title":"Impact of Major Congenital Malformation Algorithms on Their Prevalence in Large Population-Based Mother-Child Cohorts.","authors":"Gabra Nohmie, Younes Bousbaa, Odile Sheehy, Anick Bérard","doi":"10.1111/ppe.70129","DOIUrl":"10.1111/ppe.70129","url":null,"abstract":"<p><strong>Background: </strong>Major congenital malformations (MCM) affect 2%-6% of pregnancies globally. Identifying MCM using real-world data is essential, but various definitions exist with differing performances and case ascertainment criteria, limiting collaborations.</p><p><strong>Objective: </strong>To compare published definitions and algorithms to identify MCM using data from the Québec Pregnancy Cohort (QPC).</p><p><strong>Methods: </strong>We conducted a comparative study of 10 algorithms for identifying MCM using QPC, a pre-established population-based cohort of pregnancies covered by Québec's public drug insurance plan between 1998 and 2015. We included infants from singleton pregnancies (live or stillbirth) who met the minimum postnatal follow-up duration required by the applied algorithm. Infants were excluded if they had an isolated major chromosomal congenital malformation or a gestational age ≤ 20 weeks. Algorithms varied by time window of detection (28 days, 6 months, 1 year), data source considered (inpatient, outpatient), diagnostic codes (ICD-9, ICD-10) and procedural codes requirements. The prevalence of global MCM and organ-specific malformation was calculated and compared to North American prevalence.</p><p><strong>Results: </strong>Among 233,338 infants meeting inclusion criteria, global MCM prevalence ranged from 2.9% to 9.0%. Across all algorithms, the most prevalent malformations were musculoskeletal and circulatory anomalies, with prevalence ranging from 0.9% to 3.3% and from 0.4% to 2.4%, respectively. Using ≥ 1 diagnostic code in the first year of life overestimated the prevalence, whereas using ≥ 1 inpatient or ≥ 2 outpatient codes for the same organ system on different days yielded a prevalence of 5.0%, which is close to what is expected compared to international prevalences. Considering this algorithm appears well-suited to the QPC setting, where inpatient diagnostic codes have been shown to be more reliable.</p><p><strong>Conclusions: </strong>Algorithm choice substantially impacts MCM prevalence estimates. Transparent definitions enhance reproducibility and cross-study comparability in pharmacoepidemiologic research.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"477-483"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468880","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 Poverty Histories and Severe Maternal Morbidity Across California Census Tracts.","authors":"Sai Ramya Maddali, Juan Cabrera, Xing Gao, Rachel Morello-Frosch, Patrick T Bradshaw, Suzan Carmichael, Mahasin Mujahid","doi":"10.1111/ppe.70088","DOIUrl":"10.1111/ppe.70088","url":null,"abstract":"<p><strong>Background: </strong>Severe maternal morbidity (SMM) and its racial and ethnic inequities are the result of a mixture of risk factors ranging from clinical comorbidities to socio-economic contexts. One under-explored dimension is neighbourhood contexts.</p><p><strong>Objectives: </strong>In order to understand the impact of neighbourhood contexts on SMM, this study investigates the relationship between a 20-year history of neighbourhood poverty and SMM among 8.6 million births in California from 2000 to 2018 and assesses effect measure modification by race/ethnicity and nativity.</p><p><strong>Methods: </strong>Data include hospital live births in California from 2000 to 2018 from the California Department of Public Health. The final sample for this study consisted of 8,632,436 live births. Mixed-effects logistic regression models accounting for area-level clustering were used to compare the odds of SMM across neighbourhood poverty histories, adjusting for sociodemographic and pregnancy-related factors and comorbidities.</p><p><strong>Results: </strong>The prevalence of SMM was 1.2%. In fully adjusted models, neighbourhoods with persistent high poverty had 32% higher odds of SMM (OR 1.32, 95% confidence interval [CI] 1.28, 1.37), and those with persistent moderate poverty had 9% higher odds (OR 1.09, 95% CI 1.06, 1.12), compared to neighbourhoods with a persistent low poverty history. The odds of SMM were also higher in neighbourhoods with increasing poverty; 23% higher for early increase (OR 1.23, 95% CI 1.19, 1.27) and 13% higher for late increase (OR 1.13, 95% CI 1.09, 1.16). In contrast, neighbourhoods with early decreasing poverty had 11% lower odds of SMM (OR 0.89, 95% CI 0.84, 0.94) compared to persistent lowpoverty neighbourhoods.</p><p><strong>Conclusions: </strong>The findings indicate that persistent high poverty in neighbourhoods is associated with higher odds of SMM, independent of individual sociodemographic and clinical factors. The strongest associations were found among Asian, Hispanic, Pacific Islander and white birthing people. These results underscore the significance of neighbourhood poverty histories and their impact on maternal health.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"544-554"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506278","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":"Imputing Partial Birth Dates Using Day of the Week.","authors":"Candice Y Johnson","doi":"10.1111/ppe.70130","DOIUrl":"10.1111/ppe.70130","url":null,"abstract":"<p><strong>Background: </strong>In de-identified data, exact birth dates are suppressed to maintain the confidentiality of research participants. When the partial birth date includes only the month and year, researchers who need exact dates must impute a day of the month. In some deidentified datasets, the day of the week is also provided, but this variable is uncommonly incorporated into the imputation of partial dates.</p><p><strong>Objective: </strong>To examine the extent to which misclassification is reduced by incorporating the day of the week into partial birth date imputation.</p><p><strong>Methods: </strong>We simulated a population of 594,677 people using the distribution of birthdays in England and Wales in 2024. We imputed birth dates using four methods: (1) the first day of the month, (2) the 15th of the month, (3) randomly selecting a day of the month and (4) randomly selecting a day of the month conditional on the day of the week. We quantified misclassification as the median number of days between the imputed and true birth date and as the cumulative percentage of the population whose imputed birth date fell within a given number of weeks of their true birth date.</p><p><strong>Results: </strong>Incorporating the day of the week reduced misclassification, with a median of 7 days between the imputed and exact birth dates compared to 8-15 for the other methods. For nearly a quarter of the population, their imputed birth date was their true birth date, compared to 3% in other methods. However, using the 15th day of the month was the best method to ensure that no misclassification was greater than 3 weeks.</p><p><strong>Conclusion: </strong>Incorporating day of the week into random birth date selection reduced misclassification. This method is easily accomplished in standard statistical software.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"557-559"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639523","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":"When Numbers Do Not Always Tell the Full Story: The Preterm Black Male Survival Paradox.","authors":"Arushi Meharwal, Rachana Singh","doi":"10.1111/ppe.70155","DOIUrl":"10.1111/ppe.70155","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"462-464"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875179","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":"Educational Outcomes: An Important Domain for Child Health.","authors":"Russell S Kirby","doi":"10.1111/ppe.70157","DOIUrl":"10.1111/ppe.70157","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"526-528"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006262","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":"Exploring the Impact of Missing Death Data on Identification of Congenital Malformations in Insurance Claims Data.","authors":"Katelin B Nickel, Sascha Dublin, Sharon Fuller, Sarah S Osmundson, Ryan Colvin, Dustin Stwalley, Elyse O Kharbanda, Catherine A Panozzo, Sara S Procknow, Anne M Butler","doi":"10.1111/ppe.70146","DOIUrl":"10.1111/ppe.70146","url":null,"abstract":"<p><strong>Background: </strong>Accurate algorithms are needed to support real-world studies of medication safety in pregnancy. Kharbanda et al. developed and validated algorithms for congenital malformations that incorporate death data and diagnosis codes from the ICD-9-CM and ICD-10-CM coding eras.</p><p><strong>Objectives: </strong>To modify an EHR-based malformation algorithm for use with claims data and quantify the impact of missing death by calculating prevalence and sensitivity.</p><p><strong>Methods: </strong>Using the MarketScan Commercial Database (2007-2022), we established a linked cohort of birthing parents and their liveborn infants, and a claims subcohort restricted to years with inpatient death information. We established a cohort of liveborn infants in Kaiser Permanente Washington (KPWA) integrated EHR/claims data (2007-2022) that included comprehensive death information. We applied the validated algorithm to identify 22 malformations in MarketScan and 7 in KPWA (those with a prevalence ≥ 10 per 10,000 live births in MarketScan). In MarketScan, we calculated malformation prevalence with and without death information. We assessed the contribution of death on malformation identification by calculating sensitivity (with death as the gold standard).</p><p><strong>Results: </strong>Among 2,203,328 infants in the MarketScan cohort, malformation prevalence was 201.3 per 10,000 live births. In the MarketScan subcohort (n = 1,287,384), prevalence was 198.2 and 199.1 per 10,000 live births without and with death information, respectively. Among the most prevalent malformations, estimated sensitivity ranged from 95.8% for severe cardiac defects to 100.0% for intestinal atresia or stenosis, pyloric stenosis and limb deficiency (claims/EHR cohort) and from 98.6% for severe cardiac defects to 100.0% for intestinal atresia or stenosis and pyloric stenosis (claims subcohort). Limitations include the use of an imperfect gold standard and a lack of chart review.</p><p><strong>Conclusions: </strong>We adapted a validated malformation algorithm for use with claims data. Omitting death information did not meaningfully impact sensitivity, suggesting this algorithm can be applied to data sources lacking death information.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"471-476"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639551","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":"Buffering the Block: Can Individual Interventions Offset Neighbourhood Harms to Pregnancy?","authors":"Teresa Janevic, Dana E Goin","doi":"10.1111/ppe.70149","DOIUrl":"10.1111/ppe.70149","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"541-543"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777804","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":"Influence of Gestational Age Measurement Technique on the Associations Between Maternal Characteristics and Birth Outcomes.","authors":"Ginna L Doss, Julie L Daniels, Sunni L Mumford, Charles Poole, Anne Z Steiner, Enrique F Schisterman, Robert M Silver, Anne Marie Z Jukic","doi":"10.1111/ppe.70135","DOIUrl":"10.1111/ppe.70135","url":null,"abstract":"<p><strong>Background: </strong>Associations of factors of interest with preterm birth and small for gestational age (SGA) may be impacted by the technique used to measure gestational age at birth.</p><p><strong>Objective: </strong>To compare the associations of several factors with preterm birth and SGA when gestational age was measured with three different techniques.</p><p><strong>Methods: </strong>Among participants with a live birth in the Effects of Aspirin in Gestation and Reproduction (EAGeR) trial, this study used three methods to estimate gestational age: 1) prospective fertility monitor ovulation, 2) prospective LMP, and 3) early ultrasound. The study assigned the outcomes of preterm birth and SGA by each method among participants with complete gestational age information (N = 392). The study reported unadjusted prevalence differences (PDs) and 95% confidence intervals (CIs) for preterm birth and SGA, by each method, with two commonly measured maternal characteristics: age ≥ 35 years (versus < 35) and body mass index ≥ 25 kg/m² (versus < 25), and with aspirin treatment (versus placebo).</p><p><strong>Results: </strong>For all but one characteristic-outcome pair examined, unadjusted PDs were similar, within 3 percentage points, for all gestational age measurement techniques. The largest discrepancy among the PDs was in the association of age ≥ 35 years with preterm birth: PD = 6% (95% CI: -6, 17) when defined by ovulation, 1% (95% CI: -10, 11) by ultrasound, and 2% (95% CI: -8, 11) by LMP. Precision of the PDs, as assessed by their confidence limit differences, did not identify a consistently more precise gestational age measurement technique.</p><p><strong>Conclusions: </strong>Even when gestational age was measured prospectively and early in pregnancy, small differences in the classification of preterm birth and SGA were found. These differences have the potential to bias the association of maternal characteristics with these outcomes. This should be considered by researchers, particularly in populations where the gestational age assignment technique is unknown.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":"40 4","pages":"465-470"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043024","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":"Educational Attainment of Children With Major Congenital Anomalies During Primary School in England: A Population Cohort Study.","authors":"Joachim Tan, Ayana Cant, Kate Lewis, Vincent Nguyen, Laura Gimeno, Ania Zylbersztejn, Pia Hardelid, Joan Morris, Bianca De Stavola, Katie Harron, Ruth Gilbert","doi":"10.1111/ppe.70122","DOIUrl":"10.1111/ppe.70122","url":null,"abstract":"<p><strong>Background: </strong>Major congenital anomalies (CA) affect 2.3% of livebirths and are associated with lower educational attainment. Understanding attainment trajectories throughout primary school would inform parents, schools and organisations and help plan support.</p><p><strong>Objectives: </strong>We compared school enrolment and attainment at ages 5, 7 and 11 in children with different CA and their peers in England using the Education and Child Health Insights using Linked Data database.</p><p><strong>Methods: </strong>We included all singleton children born in NHS-funded hospitals from September 2003 to August 2008 who enrolled in state-funded schools at ages 4-5. CA were identified from hospital diagnoses, procedures or death records. We described school enrolment, school-readiness, the percentage who sat curriculum assessments and who achieved expected English and Maths attainment at three ages. We estimated risk ratios of children with CA achieving expected attainment compared with peers, adjusting for sociodemographic factors.</p><p><strong>Results: </strong>Of 2,351,589 children enrolled at age 5, 78,847 (3.5%) had CA. At age 11, 88.7% of enrolled children with CA sat assessments versus 97.2% of peers. Proportionally fewer children with CA (45.7%) were school-ready at age 5 versus peers (57.0%). For English, 56.9%, 55.4% and 65.3% of children with CA achieved expected levels at ages 5, 7 and 11 respectively, consistently 11%-12% fewer than peers; similar gaps persisted for Maths. Children with CA were less likely than peers to achieve expected attainment (adjusted risk ratio [aRR], 0.86, 95% confidence interval [CI] 0.85, 0.86), but this varied substantially (aRR 0.01, 95% CI 0.01, 0.02 for Down syndrome; aRR 1.04, 95% CI 0.96, 1.12 for unilateral renal agenesis).</p><p><strong>Conclusions: </strong>Attainment gaps between children with CA and peers remained unchanged across subjects and ages, with proportionally fewer sitting assessments at age 11. Better monitoring and support for these children from school entry could help optimise learning experiences and fulfil their academic potential.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"511-525"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147308690","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":"Inflated Denominators, Selection In Utero, and the Black Male Neonatal Death Paradox.","authors":"Ralph Catalano, Brenda Bustos, Emtiaz Hritan, Joan A Casey, Alison Gemmill, Hedwig Lee, Dana Sarnak, Tim Bruckner","doi":"10.1111/ppe.70127","DOIUrl":"10.1111/ppe.70127","url":null,"abstract":"<p><strong>Background: </strong>Epidemiologists speculate that comparatively high rates of fetal death among males conceived by non-Hispanic Black (NHB) women in the United States (USA) could explain the unexpectedly low neonatal death rate among extremely preterm (ePTB) NHB males. Consistent with this 'selection in utero' argument, conception cohorts exhibiting high sex ratios (M:F) of NHB stillbirths reportedly exhibit greater NHB advantages in ePTB male neonatal death rates. Sceptics, however, attribute this association to an artefact that spuriously inflates the denominators of neonatal death rates in highly stressed populations.</p><p><strong>Objective: </strong>To determine whether the positive association over conception cohorts between the NHB male neonatal death advantage and the sex ratio of NHB stillbirths survives correction for inflated denominators.</p><p><strong>Methods: </strong>We retrieved vital statistics for NHB and non-Hispanic white (NHW) singleton ePTB infants born in the USA from 1995 through 2018. We aggregated these data into 282 monthly conception cohorts. We avoided the inflated denominator problem by substituting a 'NHB share of burden' variable for the difference between NHB and NHW neonatal death rates. We specify this variable as the NHB proportion of neonatal deaths among NHB and NHW ePTB males born from each conception cohort. We determined, using Box-Jenkins methods, whether cohorts exhibiting unusually high sex ratios of NHB stillbirths also exhibited unusually low NHB shares of the burden of ePTB male neonatal death.</p><p><strong>Results: </strong>Consistent with the selection in utero argument, the NHB share of neonatal deaths among ePTB males fell 7% below expected among the cohorts exhibiting unusually high sex ratios of NH Black stillbirths.</p><p><strong>Conclusions: </strong>Stillbirth affects the composition of birth cohorts by selecting against less fit males in conception cohorts. Although clinical manifestations of this bias remain largely unexplored, they likely include the Black male neonatal death paradox.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"454-461"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378351","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}