Paediatric and perinatal epidemiology最新文献

{"title":"The Effectiveness of the Palivizumab Programme in Reducing the Risk of Paediatric Asthma: A Population-Based Study in Ontario, Canada.","authors":"Kimberley A Foley, Sarah A Buchan, Dayre McNally, Michelle Dimitris, Sarah Swayze, Jeffrey C Kwong, Steven Hawken, Sonia Saxena, Dougal Hargreaves, Tiffany Fitzpatrick","doi":"10.1111/ppe.70141","DOIUrl":"10.1111/ppe.70141","url":null,"abstract":"<p><strong>Background: </strong>Palivizumab was introduced in Canada in 1998 as a publicly funded programme to reduce respiratory syncytial virus (RSV) disease in high-risk children. Severe early-life RSV infections are associated with increased asthma risk. Thus, palivizumab may also indirectly reduce paediatric asthma.</p><p><strong>Objective: </strong>To evaluate the effectiveness of Ontario, Canada's palivizumab programme in decreasing paediatric asthma.</p><p><strong>Methods: </strong>We used multiple linked population-based administrative databases to identify all children born in Ontario between 1993 and 2013, with follow-up through March 2020. Our primary outcome was physician-diagnosed asthma by age 7. Controlled interrupted time-series analysis was used to compare changes in annual asthma incidence (by birth year) before and after palivizumab's introduction, according to programme eligibility (clearly, possibly, or ineligible). Socio-demographic differences were explored via stratification.</p><p><strong>Results: </strong>Nearly 3 million children were included in this study, including 406,596 (14.6%) diagnosed with asthma by age 7. Asthma incidence substantially declined over the study period, with the greatest declines among palivizumab-ineligible children (35.3%, 95% confidence interval [CI] 28.3, 42.6, versus 18.1%, 95% CI 13.9, 22.9 among clearly eligible children). However, relative to ineligible children, post-palivizumab declines were most apparent among possibly eligible children, with an additional annual decline of 2.0% (95% CI 0.3, 3.7) in asthma. Socio demographic differences in asthma incidence and post-palivizumab declines were noted. Particularly, incidence was higher among children born to teenage mothers than among those aged 19+ years; this gap narrowed over time, especially among possibly eligible children.</p><p><strong>Conclusions: </strong>Asthma incidence declined over this 20-year study; however, smaller declines were observed among children clearly eligible for palivizumab relative to ineligible children. However, exploratory evidence was suggestive of reduced social inequities in asthma post-palivizumab, particularly among possibly eligible children. Larger reductions in asthma might be realized with the introduction of population-based RSV immunization programmes through broader programme eligibility and reductions in severe RSV disease.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"484-496"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581995","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 Role of Social Support as a Buffer Against Adverse Birth Outcomes Among People Experiencing Neighbourhood Deprivation.","authors":"Meredith A Dixon, Suchitra Chandrasekaran, Howard H Chang, Michael R Kramer, Tené T Lewis, Penelope P Howards","doi":"10.1111/ppe.70113","DOIUrl":"10.1111/ppe.70113","url":null,"abstract":"<p><strong>Background: </strong>Previous research has shown an association between neighbourhood context and adverse birth outcomes, but with high heterogeneity.</p><p><strong>Objective: </strong>To examine the degree to which social support buffers against the adverse effects of neighbourhood deprivation on preterm birth and small for gestational age (SGA).</p><p><strong>Methods: </strong>This study is a secondary analysis of data from the nuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be) longitudinal cohort study, which recruited participants between 2010 and 2013. We estimated prevalence differences (PD) for area deprivation index (ADI) and for social support with each adverse birth outcome, and we evaluated whether the effect of ADI was modified by perceived social support; we additionally stratified by race/ethnicity. All models were adjusted for maternal age and education.</p><p><strong>Results: </strong>Our analytic sample included n = 8377 participants. Among the birth outcomes we investigated, high social support had the strongest association with preterm birth. Participants reporting high social support had three fewer cases of preterm birth per 100 pregnancies (PD = -0.03, 95% CI -0.05, 0.00), compared to participants reporting low or moderate social support. The only evidence of high social support buffering against the harmful effects of neighbourhood deprivation was seen with SGA. Among participants with low or moderate social support, a 25-percentile increase in ADI was associated with two excess cases of SGA per 100 pregnancies (PD = 0.02, 95% CI -0.01, 0.04); whereas among participants with high social support, there was a null effect (PD = 0.00, 95% CI -0.01, 0.01). This effect modification was seen mostly among non-Hispanic White individuals.</p><p><strong>Conclusion: </strong>Social support might offer some protection against the effects of neighbourhood deprivation on SGA, perhaps more so for non-Hispanic White people. However, we did not find evidence of social support buffering against the effects of neighbourhood deprivation on preterm birth.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"529-540"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952531","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":"Periconceptional Hormonal Contraception Use and Autism Spectrum Disorder in the Study to Explore Early Development.","authors":"Michelle T Delahanty, Stephanie Engel, Dani Fallin, Tanya Garcia, Christine Ladd-Acosta, Anne Steiner, Mollie Wood, Julie L Daniels","doi":"10.1111/ppe.70049","DOIUrl":"10.1111/ppe.70049","url":null,"abstract":"<p><strong>Background: </strong>Prior studies report associations between periconceptional exposure to natural and synthetic oestrogen and progesterone and autism spectrum disorder (ASD). Hormonal contraception contains synthetic forms of one or both hormones. Although hormonal contraception is highly effective when consistently used, unintended pregnancy can occur with irregular use. Given the popularity of hormonal contraception, foetal exposure in utero is possible, yet the potential consequences are unknown.</p><p><strong>Objectives: </strong>We investigated the association between periconceptional hormonal contraception use and the development of ASD in offspring.</p><p><strong>Methods: </strong>We analysed data from the Study to Explore Early Development (SEED), a population-based case-control study conducted in select US states, from 2007 to 2020. Children with and without ASD were identified from clinical/education sources and vital records, respectively, and enrolled at ages 2.5-5 years. We confirmed the ASD case status by in-person developmental assessment. We assessed hormonal contraception via a structured interview. We assessed the associations between ASD and hormonal contraception exposure separately for contraception discontinued in the 3 months prior to pregnancy and contraception continued during pregnancy using logistic models to estimate odds ratios (OR) adjusted for biological mother age, education, parity, pre-pregnancy body mass index (BMI), and presence of gynaecologic conditions and 95% confidence intervals (CI).</p><p><strong>Results: </strong>Of 5210 participants, 9.9% reported discontinuing hormonal contraception use before pregnancy and 2.3% reported continuing use during pregnancy. A suggestive association was found between ASD and hormonal contraception use during pregnancy (aOR 1.38,95% CI 0.93, 2.05). There was no association with use prior to pregnancy (aOR 1.02, 95% CI 0.84, 1.25).</p><p><strong>Conclusions: </strong>Discontinuation of hormonal contraception prior to conception was not associated with ASD. The prevalence of hormonal contraception use during pregnancy was low. Results were imprecise and may be impacted by recall bias and unmeasured confounding by indication and health behaviours related to planning pregnancy.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"500-510"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125718","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":"Rethinking Maternal Obesity Research in a Changing Clinical Landscape.","authors":"Jennifer A Hutcheon, Lisa M Bodnar","doi":"10.1111/ppe.70100","DOIUrl":"10.1111/ppe.70100","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"555-556"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12892908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678246","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":"Associations Between Mental Health Conditions and Adverse Pregnancy Outcomes Among Active-Duty Servicewomen.","authors":"Laura L Manzo, Clinton Hall, Joan Combellick, Ilan Harpaz-Rotem, Angela K Phillips, Monica T Burrell, Chrystelle Kiang, Julie A Womack","doi":"10.1111/ppe.70139","DOIUrl":"10.1111/ppe.70139","url":null,"abstract":"<p><strong>Background: </strong>Active-duty servicewomen (ADSW) are at increased risk for mental health conditions compared to civilian women. Research suggests women with mental health conditions experience serious pregnancy complications at rates 50% higher than those without mental health conditions; yet research in military populations is limited.</p><p><strong>Objective: </strong>To explore associations between mental health conditions and adverse pregnancy outcomes among ADSW.</p><p><strong>Methods: </strong>Department of Defence data were used to identify a cohort of live birth pregnancies among ADSW that started and ended between October 2016 and December 2021. Mental health conditions diagnosed in the year prior to or during pregnancy (trauma/stressor-related disorders, anxiety/panic, depression, eating disorders and suicidal ideation/attempt) and adverse pregnancy outcomes (hypertensive disorders of pregnancy, gestational diabetes, peripartum cardiomyopathy, postpartum haemorrhage and preterm birth) were identified using ICD-10-CM codes. Mental health conditions were assessed as any diagnosis or none, and as a count of comorbid diagnoses (1, 2 or 3+). Modified Poisson regression models estimated adjusted risk ratios (RR) with 95% confidence intervals (CI) to quantify associations of mental health diagnoses with adverse pregnancy outcomes, overall and stratified by demographic characteristics.</p><p><strong>Results: </strong>Overall, 62,729 deliveries among 54,471 ADSW were included. Deliveries among ADSW with diagnosed mental health conditions relative to those with none demonstrated increased risk for adverse pregnancy outcomes (RR 1.07, 95% CI 1.04, 1.11). Deliveries among ADSW with 3+ mental health conditions had the highest risk for an adverse pregnancy outcome (RR 1.17, 95% CI 1.10, 1.25). Individually, mental health conditions were associated with increased risk of preterm birth (RR 1.18, 95% CI 1.10, 1.26) and gestational diabetes (RR 1.14, 95% CI 1.06, 1.22).</p><p><strong>Conclusions: </strong>This study highlights the increased risk for adverse pregnancy outcomes among ADSW with mental health conditions. Enhanced screening and subsequent treatment of these mental health diagnoses can be a mechanism to decrease adverse pregnancy outcomes.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513715","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":"Postpartum Depression in Fathers Following Medically Assisted Reproduction: A Register-Based Cohort Study.","authors":"Mette Bliddal, Trine Munk-Olsen, Xiaoqin Liu, Sofie Egsgaard","doi":"10.1111/ppe.70107","DOIUrl":"10.1111/ppe.70107","url":null,"abstract":"<p><strong>Background: </strong>Undergoing medically assisted reproduction (MAR) has been linked to adverse mental health outcomes, yet research examining whether MAR is associated with paternal postpartum depression (PPD) remains sparse. We investigated the risk of PPD among fathers of children conceived with MAR compared to fathers of children conceived unassisted.</p><p><strong>Methods: </strong>Using the nationwide health registers, we included all fathers of children born in Denmark between 2010 and 2019. We categorised children as conceived unassisted or by MAR, linking childbirths to MAR treatments and further classified MAR conception according to the type and duration of treatment, and by indication for MAR. PPD was identified using a hospital depression diagnosis or antidepressant prescriptions within 12 months postpartum. We conducted adjusted Poisson regression analyses accounting for relevant covariates, including socioeconomic factors and clustering due to multiple children born to the same fathers.</p><p><strong>Results: </strong>The study population included 413,682 births, of which 31,128 (7.5%) were conceived with MAR. Fathers in the MAR group were older, more often first-time parents, and had higher education and income levels. Within each group, 0.9% (270 with MAR conception, 3542 with unassisted conception) experienced PPD. We observed a 22% higher risk of PPD among fathers with MAR conception compared to unassisted conception after adjustment (adjusted relative risk [aRR] 1.22, 95% confidence interval [CI] 1.07, 1.38). Elevated risks were consistent across MAR types, treatment duration, and infertility indications, with the highest risk associated with treatment durations exceeding 12 months (aRR 1.42, CI 1.11, 1.80).</p><p><strong>Conclusions: </strong>We observed an increased risk of PPD among fathers of children conceived with MAR compared to fathers of children conceived unassisted. These findings suggest the need for greater awareness and targeted support for this group in early parenthood.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"321-325"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687767","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":"Fertility Rates in Women With Intellectual and Developmental Disabilities: New Evidence and Ongoing Gaps.","authors":"Hilary K Brown","doi":"10.1111/ppe.70133","DOIUrl":"10.1111/ppe.70133","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"318-320"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434119","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":"Response to: Is the Most Likely Value Also the Best Imputation?","authors":"Takamasa Sakai, Hedvig Nordeng, Marleen M H J van Gelder","doi":"10.1111/ppe.70119","DOIUrl":"10.1111/ppe.70119","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"429-430"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113771","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":"Estimating Causal Effects of Third-Stage Management on Postpartum Haemorrhage in a Midwifery Context: An Evidence Synthesis Approach for Constructing Directed Acyclic Graphs.","authors":"Vanessa Hébert, Irina I Oltean, Giulia M Muraca, Nancy Santesso, Elizabeth K Darling","doi":"10.1111/ppe.70072","DOIUrl":"10.1111/ppe.70072","url":null,"abstract":"<p><strong>Background: </strong>Estimating the causal effect of third-stage management approaches on preventing postpartum haemorrhage (PPH) in the context of physiologic birth using observational data requires conditioning on specific variables, with selection relying on assumptions about their roles in the exposure-outcome pathway that are rarely made explicit.</p><p><strong>Objectives: </strong>To apply the evidence synthesis for constructing DAGs approach, incorporating findings from a systematic review, to develop a causal directed acyclic graph (DAG) that clarifies these assumptions and identifies the minimum set of variables needed to reduce bias in estimating the causal effects of physiologic third-stage care versus oxytocin prophylaxis on PPH.</p><p><strong>Data sources: </strong>MEDLINE, Embase, CINAHL, Web of Science, and Cochrane Central Register of Controlled Trials (to December 15, 2023), ClinicalTrials.gov (to July 8, 2024), and reference lists of eligible studies.</p><p><strong>Study selection and data extraction: </strong>The systematic review included randomised and non-randomised studies involving individuals with physiologic birth or minimal obstetric interventions. Two authors independently screened studies. DAG development was based on the subset of non-randomised studies. For each, one reviewer extracted outcome, exposure, control variables and mediators.</p><p><strong>Synthesis: </strong>Eligible studies were analysed in three stages: (i) mapping each study's saturated implied graph; (ii) translating each posited connection using causal criteria to create study-specific DAGs; (iii) synthesising individual DAGs into an integrated DAG. The assumptions underlying this process were specific to the midwifery context in Ontario, Canada and translation was guided by midwifery expertise and existing literature.</p><p><strong>Results: </strong>Four non-randomised studies were included. Expert consultation identified 20 factors influencing third-stage management. The integrated DAG comprised 339 directed edges connecting 35 covariates, yielding four minimal sufficient adjustment sets.</p><p><strong>Conclusions: </strong>The integrated DAG and minimal sufficient adjustment sets are valuable tools for informing future study design and analysis, helping to minimise bias in estimating the causal effect of physiologic third-stage care versus oxytocin prophylaxis on PPH in the context of physiologic birth, while also exposing the assumptions about causal relationships between variables to scrutiny.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"388-396"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081002","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":"Are We Finally Bending the Curve? Paediatric Antibiotic Use in Australia and the Next Frontier for Stewardship.","authors":"Jan Y Verbakel","doi":"10.1111/ppe.70103","DOIUrl":"10.1111/ppe.70103","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"349-351"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649193","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}