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Shukla VV, Carper BA, Ambalavanan N, Rysavy MA, Bell EF, Das A, Patel RM, D'Angio CT, Watterberg KL, Cotten CM, Merhar SL, Wyckoff MH, Sánchez PJ, Kumbhat N, Carlo WA. Social distancing and extremely preterm births in the initial COVID-19 pandemic period. J Perinatol 2024; 44:1050-1057. [PMID: 38388715 PMCID: PMC11226398 DOI: 10.1038/s41372-024-01898-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024]
Abstract
HYPOTHESIS Increased social distancing was associated with a lower incidence of extremely preterm live births (EPLB) during the initial COVID-19 pandemic period. STUDY DESIGN Prospective study at the NICHD Neonatal Research Network sites comparing EPLB (220/7-286/7 weeks) and extremely preterm intrapartum stillbirths (EPIS) rates during the pandemic period (March-July, weeks 9-30 of 2020) with the reference period (same weeks in 2018 and 2019), correlating with state-specific social distancing index (SDI). RESULTS EPLB and EPIS percentages did not significantly decrease (1.58-1.45%, p = 0.07, and 0.08-0.06%, p = 0.14, respectively). SDI was not significantly correlated with percent change of EPLB (CC = 0.29, 95% CI = -0.12, 0.71) or EPIS (CC = -0.23, 95% CI = -0.65, 0.18). Percent change in mean gestational age was positively correlated with SDI (CC = 0.49, 95% CI = 0.07, 0.91). CONCLUSIONS Increased social distancing was not associated with change in incidence of EPLB but was associated with a higher gestational age of extremely preterm births. CLINICALTRIALS GOV ID Generic Database: NCT00063063.
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Affiliation(s)
- Vivek V Shukla
- Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Benjamin A Carper
- Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park, NC, USA
| | | | - Matthew A Rysavy
- Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Edward F Bell
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD, USA
| | - Ravi M Patel
- Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Carl T D'Angio
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | | | | | - Stephanie L Merhar
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Myra H Wyckoff
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Pablo J Sánchez
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Neha Kumbhat
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Waldemar A Carlo
- Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, USA
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2
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Jeppegaard M, Rasmussen SC, Anhøj J, Krebs L. Winter, spring, summer or fall: temporal patterns in placenta-mediated pregnancy complications-an exploratory analysis. Arch Gynecol Obstet 2024; 309:1991-1998. [PMID: 37353564 PMCID: PMC11018682 DOI: 10.1007/s00404-023-07094-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/01/2023] [Indexed: 06/25/2023]
Abstract
PURPOSE Placenta-mediated pregnancy complications, like growth restriction and hypertensive disorders, are leading causes of maternal, fetal and neonatal morbidity and mortality in high-income countries. The purpose was to investigate if there is a seasonal variation in placenta-mediated pregnancy complications (small for gestational age, intrauterine growth restriction, preeclampsia, preterm birth and intrauterine fetal death). METHODS This is a Danish cohort study including all singleton deliveries at gestational week 22 up to and including week 41 conceived from December 2006 to November 2016 (N = 555,459). We used statistical process control charts to visualize data and to test for patterns of non-random variation in data over time for pregnancies with risk factors (BMI, diabetes, in vitro fertilization, maternal age > 40 years, primipara, previous caesarean and smoking) and each of the following outcome: fetal growth restriction, hypertensive disorders, preterm birth and intrauterine fetal death. The study was approved by the Danish Data Protection agency; REG-039-2019. RESULTS We found a seasonal pattern in hypertensive disorders during pregnancy with dips in pregnancies conceived in the fall season and highest risk by conception in the spring and summer season. We found no apparent seasonality in cases of preterm delivery, small for gestational age and intrauterine mortality. Individual risk factors (e.g. smoking and obesity) for placenta-mediated complicated over time were in consistency with the general trends. CONCLUSIONS We found a significant seasonal variation in the risk of hypertensive disorders of pregnancy with highest risk by conception in the spring and summer season. This study found no seasonal variation in other placenta-mediated complications.
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Affiliation(s)
- Maria Jeppegaard
- Department of Gynecology and Obstetrics, Copenhagen University Hospital - Holbæk, Smedelundsgade 60, 4300, Holbaek, Denmark.
- Department of Gynecology and Obstetrics, Copenhagen University Hospital - Hvidovre, Amager Hvidovre Hospital, Kettegård Allé 30, 2650, Hvidovre, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark.
| | - Steen C Rasmussen
- Department of Gynecology and Obstetrics, Copenhagen University Hospital - Holbæk, Smedelundsgade 60, 4300, Holbaek, Denmark
- Department of Gynecology and Obstetrics, Copenhagen University Hospital - Hvidovre, Amager Hvidovre Hospital, Kettegård Allé 30, 2650, Hvidovre, Denmark
- Centre of Diagnostic Investigation, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Jacob Anhøj
- Centre of Diagnostic Investigation, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Lone Krebs
- Department of Gynecology and Obstetrics, Copenhagen University Hospital - Hvidovre, Amager Hvidovre Hospital, Kettegård Allé 30, 2650, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
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3
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Lewis P, Gottlieb JF, Morfeld P, Hellmich M, Erren TC. Perinatal photoperiod associations with bipolar disorder and depression: A systematic literature review and cross-sectional analysis of the UK Biobank database. Psychiatry Res 2024; 335:115878. [PMID: 38581863 DOI: 10.1016/j.psychres.2024.115878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/07/2024] [Accepted: 03/24/2024] [Indexed: 04/08/2024]
Abstract
Season-of-birth associations with psychiatric disorders point to environmental (co-)aetiological factors such as natural photoperiod that, if clarified, may allow interventions toward prevention. We systematically reviewed the literature concerning season-of-birth and bipolar disorder and depression and explored associations between the perinatal natural photoperiod and these outcomes in a cross-sectional analysis of the UK Biobank database. We used mean daily photoperiod and relative photoperiod range (relative to the mean) in the 3rd trimester and, separately, in the first 3 months post birth as metrics. From review, increased risk of depression with late spring birth is compatible with increased odds of probable single episode-, probable recurrent-, and diagnosed depression (OR 2.85 95 %CI 1.6-5.08, OR 2.20 95 %CI 1.57-3.1, and OR 1.48 95 %CI 1.11-1.97, respectively) with increasing 3rd trimester relative photoperiod range for participants who experienced relatively non-extreme daily photoperiods. Risk of bipolar disorder with winter-spring birth contrasted with no consistent patterns of perinatal photoperiod metric associations with bipolar disorder in the UK Biobank. As natural photoperiod varies by both time-of-year and latitude, perinatal natural photoperiods (and a hypothesized mechanism of action via the circadian timing system and/or serotonergic circuitry associated with the dorsal raphe nucleus) may reconcile inconsistencies in season-of-birth associations. Further studies are warranted.
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Affiliation(s)
- Philip Lewis
- Institute and Policlinic for Occupational Medicie, Environmental Medicine, and Prevention Research, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany.
| | - John F Gottlieb
- Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Peter Morfeld
- Institute and Policlinic for Occupational Medicie, Environmental Medicine, and Prevention Research, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Thomas C Erren
- Institute and Policlinic for Occupational Medicie, Environmental Medicine, and Prevention Research, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
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4
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Wu Y, Ye H, Yuan Y, Kong C, Jing W, Liu J, Liu M. Association between season of conception, month of conception with preterm birth in China: a population-based retrospective cohort study. Reprod Health 2023; 20:88. [PMID: 37312160 DOI: 10.1186/s12978-023-01636-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/05/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Seasonal patterns of preterm birth were identified in previous studies, but the effect of conception season on preterm birth has not been extensively studied. Based on the notion that the etiological roots of preterm birth lie in the beginning of pregnancy, we did a population-based retrospective cohort study in Southwest China to examine the effects of season of conception and month of conception on preterm birth. METHODS We did a population-based retrospective cohort study in women (aged 18-49) who participated in the NFPHEP from 2010 to 2018, and had a singleton livebirth in southwest China. According to the time of the last menstruation reported by the participants, month of conception and season of conception were then ascertained. We used multivariate log-binomial model to adjust the potential risk factors for preterm birth and obtained adjusted risk ratio (aRR) and 95% confidence intervals (95%CI) for conception season, conception month and preterm birth. RESULTS Among 194 028 participants, 15 034 women had preterm birth. Compared with pregnancies that were conceived in the summer, pregnancies that were conceived in the spring, autumn and winter had the higher risk of preterm birth (Spring: aRR = 1.10, 95% CI: 1.04-1.15; Autumn: aRR = 1.14, 95% CI: 1.09-1.20; Winter: aRR = 1.28, 95% CI: 1.22-1.34) and also had a higher risk of early preterm birth (Spring: aRR = 1.09, 95% CI: 1.01-1.18; Autumn: aRR = 1.09, 95% CI: 1.01-1.19; Winter: aRR = 1.16, 95% CI: 1.08-1.25). Pregnancies in December, and January had a higher risk of preterm birth and early preterm birth than pregnancies that were conceived in July. CONCLUSIONS Our study found that preterm birth was significantly related to season of conception. Preterm and early preterm birth rates were the highest among pregnancies that were conceived in winter, and the lowest among pregnancies in summer.
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Affiliation(s)
- Yu Wu
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Hanfeng Ye
- Yunnan Population and Family Planning Research Institute, No. 146, Qingnian Road, Wuhua District, Kunming, 650021, Yunnan, China
| | - Yanling Yuan
- Yunnan Population and Family Planning Research Institute, No. 146, Qingnian Road, Wuhua District, Kunming, 650021, Yunnan, China
| | - Cai Kong
- Yunnan Population and Family Planning Research Institute, No. 146, Qingnian Road, Wuhua District, Kunming, 650021, Yunnan, China
| | - Wenzhan Jing
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Jue Liu
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Min Liu
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China.
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5
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Calvert C, Brockway MM, Zoega H, Miller JE, Been JV, Amegah AK, Racine-Poon A, Oskoui SE, Abok II, Aghaeepour N, Akwaowo CD, Alshaikh BN, Ayede AI, Bacchini F, Barekatain B, Barnes R, Bebak K, Berard A, Bhutta ZA, Brook JR, Bryan LR, Cajachagua-Torres KN, Campbell-Yeo M, Chu DT, Connor KL, Cornette L, Cortés S, Daly M, Debauche C, Dedeke IOF, Einarsdóttir K, Engjom H, Estrada-Gutierrez G, Fantasia I, Fiorentino NM, Franklin M, Fraser A, Gachuno OW, Gallo LA, Gissler M, Håberg SE, Habibelahi A, Häggström J, Hookham L, Hui L, Huicho L, Hunter KJ, Huq S, Kc A, Kadambari S, Kelishadi R, Khalili N, Kippen J, Le Doare K, Llorca J, Magee LA, Magnus MC, Man KKC, Mburugu PM, Mediratta RP, Morris AD, Muhajarine N, Mulholland RH, Bonnard LN, Nakibuuka V, Nassar N, Nyadanu SD, Oakley L, Oladokun A, Olayemi OO, Olutekunbi OA, Oluwafemi RO, Ogunkunle TO, Orton C, Örtqvist AK, Ouma J, Oyapero O, Palmer KR, Pedersen LH, Pereira G, Pereyra I, Philip RK, Pruski D, Przybylski M, Quezada-Pinedo HG, Regan AK, Rhoda NR, Rihs TA, Riley T, Rocha TAH, Rolnik DL, Saner C, Schneuer FJ, Souter VL, Stephansson O, Sun S, Swift EM, Szabó M, Temmerman M, Tooke L, Urquia ML, von Dadelszen P, Wellenius GA, Whitehead C, Wong ICK, Wood R, Wróblewska-Seniuk K, Yeboah-Antwi K, Yilgwan CS, Zawiejska A, Sheikh A, Rodriguez N, Burgner D, Stock SJ, Azad MB. Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries. Nat Hum Behav 2023; 7:529-544. [PMID: 36849590 PMCID: PMC10129868 DOI: 10.1038/s41562-023-01522-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 01/06/2023] [Indexed: 03/01/2023]
Abstract
Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from -90% to +30%, were reported in many countries following early COVID-19 pandemic response measures ('lockdowns'). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data from 52 million births in 26 countries, 18 of which had representative population-based data, with overall PTB rates ranging from 6% to 12% and stillbirth ranging from 2.5 to 10.5 per 1,000 births. We show small reductions in PTB in the first (odds ratio 0.96, 95% confidence interval 0.95-0.98, P value <0.0001), second (0.96, 0.92-0.99, 0.03) and third (0.97, 0.94-1.00, 0.09) months of lockdown, but not in the fourth month of lockdown (0.99, 0.96-1.01, 0.34), although there were some between-country differences after the first month. For high-income countries in this study, we did not observe an association between lockdown and stillbirths in the second (1.00, 0.88-1.14, 0.98), third (0.99, 0.88-1.12, 0.89) and fourth (1.01, 0.87-1.18, 0.86) months of lockdown, although we have imprecise estimates due to stillbirths being a relatively rare event. We did, however, find evidence of increased risk of stillbirth in the first month of lockdown in high-income countries (1.14, 1.02-1.29, 0.02) and, in Brazil, we found evidence for an association between lockdown and stillbirth in the second (1.09, 1.03-1.15, 0.002), third (1.10, 1.03-1.17, 0.003) and fourth (1.12, 1.05-1.19, <0.001) months of lockdown. With an estimated 14.8 million PTB annually worldwide, the modest reductions observed during early pandemic lockdowns translate into large numbers of PTB averted globally and warrant further research into causal pathways.
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Affiliation(s)
- Clara Calvert
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Meredith Merilee Brockway
- Children's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Helga Zoega
- School of Population Health, Faculty of Medicine & Health, University of New South Wales Sydney, Sydney, New South Wales, Australia
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Jessica E Miller
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Jasper V Been
- Division of Neonatology, Department of Paediatrics; Department of Obstetrics and Gynaecology; Department of Public Health; Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Adeladza Kofi Amegah
- Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | | | - Ishaya I Abok
- Department of Pediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Nima Aghaeepour
- Department of Anesthesiology, Pain, and Perioperative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Christie D Akwaowo
- Institute of Health Research and Development, University of Uyo Teaching Hospital, Uyo, Nigeria
- College of Health Sciences, University of Uyo, Uyo, Nigeria
| | - Belal N Alshaikh
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Adejumoke I Ayede
- Department of Pediatrics, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | | | - Behzad Barekatain
- Department of Pediatrics, Division of Neonatology, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Karolina Bebak
- Obstetrics and Gynaecology Ward, District Public Hospital in Poznań, Poznań, Poland
| | - Anick Berard
- Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada
- CHU Ste-Justine, Montreal, Quebec, Canada
- Faculty of Medicine, Université Claude Bernard Lyon 1, Lyon, France
| | - Zulfiqar A Bhutta
- Center of Excellence in Women Child Health, The Aga Khan University, Karachi, Pakistan
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jeffrey R Brook
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Lenroy R Bryan
- Department of Obstetrics & Gynaecology and Child Health, University of The West MonaIndies, Mona, Jamaica
| | - Kim N Cajachagua-Torres
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- The Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Centro de Investigación en Salud Materna e Infantil and Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Marsha Campbell-Yeo
- School of Nursing, Dalhousie University and IWK Health, Halifax, Nova Scotia, Canada
| | - Dinh-Toi Chu
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Vietnam
| | - Kristin L Connor
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Luc Cornette
- AZ St-Jan Bruges-Ostend AV Hospital, Bruges, Belgium
| | - Sandra Cortés
- Department of Public Health, School of Medicine, Advanced Center for Chronic Diseases Diagonal (ACCDIS), Santiago, Chile
| | - Mandy Daly
- Irish Neonatal Health Alliance, Wicklow, Ireland
| | - Christian Debauche
- Department of Neonatology, Cliniques Universitaires Saint-Luc, IREC, UCLouvain, Brussels, Belgium
- CEpiP (Centre d'Epidémiologie Périnatale), Brussels, Belgium
| | | | - Kristjana Einarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Hilde Engjom
- Department of Health Registry Research and Development, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Ilaria Fantasia
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo Children's Hospital, Trieste, Italy
| | - Nicole M Fiorentino
- Children's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Meredith Franklin
- Department of Statistical Sciences and School of the Environment, University of Toronto, Toronto, Ontario, Canada
| | - Abigail Fraser
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Onesmus W Gachuno
- Obstetrics and Gynecology, Medicine, University of Nairobi, Nairobi, Kenya
| | - Linda A Gallo
- School of Biomedical Sciences, The University of Queensland, St. Lucia, Queensland, Australia
| | - Mika Gissler
- Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Abbas Habibelahi
- Neonatology, Neonatal Health Office, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Lauren Hookham
- St. George's University, Makerere University - Johns Hopkins University Research Collaboration, London, UK
| | - Lisa Hui
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Luis Huicho
- Centro de Investigación en Salud Materna e Infantil, Centro de Investigación para el Desarrollo Integral y Sostenible and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Sayeeda Huq
- Nutrition and Clinical Services Division, ICDDR,B (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | | | - Seilesh Kadambari
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narjes Khalili
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Joanna Kippen
- Obstetrics and Gynaecology Ward, District Public Hospital in Poznań, Poznań, Poland
| | - Kirsty Le Doare
- International Centre for Neonatal and Paediatric Infection, St. George's, University of London, London, UK
- Medical Research Council/Uganda Virus Research Institute and London School of Medical Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Javier Llorca
- Universidad de Cantabria, Santander, Spain
- CIBERESP (Consortium for Biomedical Research in Epidemiology & Public Health, en Epidemiología y Salud Pública), Madrid, Spain
| | - Laura A Magee
- Institute of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Kenneth K C Man
- Research Department of Practice and Policy, University College London School of Pharmacy, London, UK
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong, Hong Kong
| | - Patrick M Mburugu
- Department of Child Health and Paediatrics, School of Medicine, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Rishi P Mediratta
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Nazeem Muhajarine
- Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Livia Nagy Bonnard
- Melletted a helyem Egyesület, Right(s) Beside You Association, Budapest, Hungary
| | - Victoria Nakibuuka
- Department of Paediatrics, St. Francis Nsambya Hospital, Kampala, Uganda
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sylvester D Nyadanu
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- Education, Culture, and Health Opportunities (ECHO) Research Group International, Aflao, Ghana
| | - Laura Oakley
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Adesina Oladokun
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Oladapo O Olayemi
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | | | - Rosena O Oluwafemi
- Department of Paediatrics and Child Health, Mother and Child Hospital, Akure, Nigeria
| | - Taofik O Ogunkunle
- Department of Paediatrics, Dalhatu Araf Specialist Hospital, Lafia, Nigeria
| | | | - Anne K Örtqvist
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Obstetrics and Gynecology, Visby County Hospital, Visby, Sweden
| | - Joseph Ouma
- Makerere University - Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Oyejoke Oyapero
- Paediatrics Department, Ikorodu General Hospital, Ikorodu, Nigeria
| | - Kirsten R Palmer
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| | - Lars H Pedersen
- Department of Obstetrics and Gynecology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Gavin Pereira
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Curtin School of Population Health and enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Isabel Pereyra
- School of Nutrition, Catholic University del Maule, Region del Maule, Chile
| | - Roy K Philip
- Division of Neonatology, Department of Paediatrics, University Maternity Hospital Limerick and University of Limerick School of Medicine, Limerick, Ireland
| | - Dominik Pruski
- Obstetrics and Gynaecology Ward, District Public Hospital in Poznań, Poznań, Poland
| | - Marcin Przybylski
- Obstetrics and Gynaecology Ward, District Public Hospital in Poznań, Poznań, Poland
| | - Hugo G Quezada-Pinedo
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- The Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Centro de Investigación en Salud Materna e Infantil and Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Annette K Regan
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
| | - Natasha R Rhoda
- Paediatric Department, School of Adolescent and Child Health, University of Cape Town, Cape Town, South Africa
- Mowbray Maternity Hospital, Western Cape Department of Health, Cape Town, South Africa
| | - Tonia A Rihs
- Federal Statistical Office (FSO), Neuchâtel, Switzerland
| | - Taylor Riley
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Thiago Augusto Hernandes Rocha
- Evidence and Intelligence for Action in Health Department, Pan-American Health Organization - World Health Organization, Washington, DC, USA
| | - Daniel L Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| | - Christoph Saner
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
- Division of Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Biomedical Research, University of Bern, Bern, Switzerland
| | - Francisco J Schneuer
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Olof Stephansson
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Shengzhi Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Emma M Swift
- Faculty of Nursing, Department of Midwifery, University of Iceland, Reykjavík, Iceland
| | - Miklós Szabó
- Division of Neonatology, 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Marleen Temmerman
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Lloyd Tooke
- Department of Paediatrics, University of Cape Town, Cape Town, South Africa
| | - Marcelo L Urquia
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Peter von Dadelszen
- Institute of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - Gregory A Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Clare Whitehead
- The Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Ian C K Wong
- Research Department of Practice and Policy, University College London School of Pharmacy, London, UK
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong, Hong Kong
| | - Rachael Wood
- Usher Institute, University of Edinburgh, Edinburgh, UK
- Public Health Scotland, Edinburgh, UK
| | | | - Kojo Yeboah-Antwi
- Public Health Unit, Father Thomas Alan Rooney Memorial Hospital, Asankrangwa, Western Region, Ghana
| | | | - Agnieszka Zawiejska
- Department of Medical Simulation, Chair of Medical Education, Poznań University of Medical Sciences, Poznań, Poland
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Natalie Rodriguez
- Children's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
| | - Sarah J Stock
- Usher Institute, University of Edinburgh, Edinburgh, UK.
| | - Meghan B Azad
- Children's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
- Departments of Pediatrics and Child Health, Community Health Sciences, and Immunology, University of Manitoba, Winnipeg, Manitoba, Canada, Winnipeg, Manitoba, Canada.
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6
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Elias C, Nogueira PJ, Sousa P. Preterm birth characteristics and outcomes in Portugal, between 2010 and 2018-A cross-sectional sequential study. Health Sci Rep 2023; 6:e1054. [PMID: 36846533 PMCID: PMC9945543 DOI: 10.1002/hsr2.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/23/2022] [Accepted: 12/29/2022] [Indexed: 02/25/2023] Open
Abstract
Introduction According to the World Health Organization, 11% of all children are born prematurely, representing 15 million births annually. An extensive analysis on preterm birth, from extreme to late prematurity and associated deaths, has not been published. The authors characterize premature births in Portugal, between 2010 and 2018, according to gestational age, geographic distribution, month, multiple gestations, comorbidities, and outcomes. Methods A sequential, cross-sectional, observational epidemiologic study was conducted, and data were collected from the Hospital Morbidity Database, an anonymous administrative database containing information on all hospitalizations in National Health Service hospitals in Portugal, and coded according to the ICD-9-CM (International Classification of Diseases), until 2016, and ICD-10 subsequently. Data from the National Institute of Statistics was utilized to compare the Portuguese population. Data were analyzed using R software. Results In this 9-year study, 51.316 births were preterm, representing an overall prematurity rate of 7.7%. Under 29 weeks, birth rates varied between 5.5% and 7.6%, while births between 33 and 36 weeks varied between 76.9% and 81.0%. Urban districts presented the highest preterm rates. Multiple births were 8× more likely preterm and accounted for 37%-42% of all preterm births. Preterm birth rates slightly increased in February, July, August, and October. Overall, respiratory distress syndrome (RDS), sepsis, and intraventricular hemorrhage were the most common morbidities. Preterm mortality rates varied significantly with gestational age. Conclusion In Portugal, 1 in 13 babies was born prematurely. Prematurity was more common in predominantly urban districts, a surprise finding that warrants further studies. Seasonal preterm variation rates also require further analysis and modelling to factor in heat waves and low temperatures. A decrease in the case rate of RDS and sepsis was observed. Compared with previously published results, preterm mortality per gestational age decreased; however, further improvements are attainable in comparison with other countries.
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Affiliation(s)
- Cecília Elias
- Unidade de Saúde Publica Francisco GeorgeACES Lisboa Norte, ARSLVTLisboaPortugal
- EPI Task‐Force FMUL, Faculdade de MedicinaUniversidade de LisboaLisboaPortugal
| | - Paulo Jorge Nogueira
- EPI Task‐Force FMUL, Faculdade de MedicinaUniversidade de LisboaLisboaPortugal
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRCNOVA University LisbonLisbonPortugal
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de MedicinaUniversidade de LisboaLisboaPortugal
- Área Disciplinar Autónoma de Bioestatística (Laboratório de Biomatemática), Faculdade de MedicinaUniversidade de LisboaLisboaPortugal
- Instituto de Saúde Ambiental, Faculdade de MedicinaUniversidade de LisboaLisboaPortugal
| | - Paulo Sousa
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRCNOVA University LisbonLisbonPortugal
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7
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Chan F, Shen S, Huang P, He J, Wei X, Lu J, Zhang L, Xia X, Xia H, Cheng KK, Thangaratinam S, Mol BW, Qiu X. Blood pressure trajectories during pregnancy and preterm delivery: A prospective cohort study in China. J Clin Hypertens (Greenwich) 2022; 24:770-778. [PMID: 35651280 PMCID: PMC9180333 DOI: 10.1111/jch.14494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/24/2022] [Accepted: 04/18/2022] [Indexed: 11/26/2022]
Abstract
Women's blood pressure (BP) changes throughout pregnancy. The effect of BP trajectories on preterm delivery is not clear. The authors aim to evaluate the association between maternal BP trajectories during pregnancy and preterm delivery. The authors studied pregnant women included in the Born in Guangzhou Cohort Study in China between February 2012 and June 2016. Maternal BP was measured at antenatal visits between 13 and 40 gestational weeks, and gestational age of delivery data was collected. The authors used linear mixed models to capture the BP trajectories of women with term, and spontaneous and iatrogenic preterm delivery. BP trajectories of women with various gestational lengths (34, 35, 36, 37, 38, 39, 40 weeks) were compared. Of the 17 426 women included in the analysis, 618 (3.55%) had spontaneous preterm delivery; 158 (.91%) had iatrogenic preterm delivery; and 16 650 (95.55%) women delivered at term. The BP trajectories were all J‐shaped curves for different delivery types. Women with iatrogenic preterm delivery had the highest mean BP from 13 weeks till delivery, followed by those with spontaneous preterm delivery and term delivery (p < .001). Trajectory analysis stratified by maternal parity showed similar results for nulliparous and multiparous women. Excluding women with pre‐eclampsia and gestational hypertension (GH) significantly attenuated the aforementioned association. Also, women with shorter gestational length tend to have higher BP trajectories during pregnancy. In conclusion, Women with spontaneous preterm delivery have a higher BP from 13 weeks till delivery than women with term delivery, while women with iatrogenic preterm delivery have the highest BP.
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Affiliation(s)
- Fanfan Chan
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Songying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Peiyuan Huang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Jianrong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Xueling Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Jinhua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Lifang Zhang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Xiaoyan Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Huimin Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Clinical Research Center for Child Health, Guangdong, China
| | - Kar Keung Cheng
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Shakila Thangaratinam
- WHO Collaborating Centre for Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Ben Willem Mol
- Department of Obstetrics and Gynecology, School of Medicine, Monash University, Melbourne, Australia
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China.,Provincial Clinical Research Center for Child Health, Guangdong, China
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8
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Kenney I, Maalouf N, Adams G, Grayson K, Brown N, Howarth C, Aladangady N, Fleming P. Demand for regional level III neonatal services is not reduced during national COVID lockdowns. Early Hum Dev 2021; 163:105491. [PMID: 34710831 PMCID: PMC8526122 DOI: 10.1016/j.earlhumdev.2021.105491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 10/17/2021] [Indexed: 11/24/2022]
Abstract
Following the first peak of the COVID-19 pandemic, reports from around the world suggested a reduction in preterm deliveries during lockdown periods. We reviewed preterm admissions to a large tertiary neonatal unit in inner North East London during two United Kingdom (UK) national lockdowns in 2020 and 2021. We found no evidence of difference in admissions during two national lockdowns compared to previous years. Based on these findings, we recommend that neonatal services remain as vigilant and prepared as ever for the unpredictable nature of preterm birth, and their staff protected to provide this highly specialist care.
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Affiliation(s)
- I. Kenney
- Homerton University Hospital NHS Foundation Trust, London E9 6SR, UK
| | | | - G. Adams
- Homerton University Hospital NHS Foundation Trust, London E9 6SR, UK,Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
| | - K. Grayson
- Homerton University Hospital NHS Foundation Trust, London E9 6SR, UK
| | - N. Brown
- Homerton University Hospital NHS Foundation Trust, London E9 6SR, UK
| | - C.N. Howarth
- Homerton University Hospital NHS Foundation Trust, London E9 6SR, UK,Department of Genomics and Child Health, Queen Mary University of London, E1 2AT, UK
| | - N. Aladangady
- Homerton University Hospital NHS Foundation Trust, London E9 6SR, UK,Department of Genomics and Child Health, Queen Mary University of London, E1 2AT, UK
| | - P.F. Fleming
- Homerton University Hospital NHS Foundation Trust, London E9 6SR, UK,Department of Genomics and Child Health, Queen Mary University of London, E1 2AT, UK,Corresponding author at: Homerton University Hospital NHS Foundation Trust, London E9 6SR, UK
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9
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Gong Y, Chai J, Yang M, Sun P, Sun R, Dong W, Li Q, Zhou D, Yu F, Wang Y, Yan X, Zhang J, Zhang Y, Jiang L, Ba Y, Zhou G. Effects of ambient temperature on the risk of preterm birth in offspring of adolescent mothers in rural henan, China. ENVIRONMENTAL RESEARCH 2021; 201:111545. [PMID: 34171374 DOI: 10.1016/j.envres.2021.111545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/20/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND A number of studies have explored the association between ambient temperature and preterm birth (PTB), but rarely among adolescent mothers. OBJECTIVES To estimate the effects of ambient temperature on the risk of PTB and gestational age of newborns delivered by adolescent mothers in rural areas of Henan province. METHODS We obtained 5394 medical records of adolescent mothers with results of pre-pregnancy physical examination and pregnancy outcomes from the National Free Preconception Health Examination Project (NFPHEP) in Henan province. Meteorological information was obtained from the China Meteorological Data Sharing Service System. Individual exposure levels were evaluated with an inverse distance-weighted model. A multiple logistic regression model and multiple linear regression model were used to estimate the effects of ambient temperature on the risk of PTB and gestational age, respectively. Stratified and interaction analyses were also performed. RESULTS Of newborns in this study, 3.45% (186/5394) were PTB. Mean, maximum and minimum temperature during the entire pregnancy, especially the last 1-4 weeks of pregnancy, were positively associated with the risk of PTB and negatively associated with gestational age (P < 0.05). Nevertheless, a masking effect was observed that gestational age was positively associated with ambient temperature during the first trimester of pregnancy, due to the strongly inverse correlation between ambient temperature during the early and late stages of pregnancy. Stratified analyses showed that increasing temperature during the last 1-4 weeks of pregnancy increased the risk of PTB and decreased gestational age in newborns born in the cold season (P < 0.05). Furthermore, interaction analyses showed that birth season modified the effects of temperature on the gestational age (Pinteraction < 0.10). CONCLUSIONS Elevated ambient temperature can decrease gestational age and increase the risk of PTB in offspring of adolescent mothers in rural areas. The birth season may modify the effects of temperature on gestational age.
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Affiliation(s)
- Yongxiang Gong
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Jian Chai
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Meng Yang
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Panpan Sun
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Renjie Sun
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Wei Dong
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Qinyang Li
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Dezhuang Zhou
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Fangfang Yu
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China; Yellow River Institute for Ecological Protection & Regional Coordinated Development, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Yuhong Wang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Xi Yan
- Department of Neurology, Henan Provincial People's Hospital; Zhengzhou University People's Hospital; Henan University People's Hospital, Zhengzhou, Henan, 450001, PR China.
| | - Junxi Zhang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Yawei Zhang
- Department of Environment Health Science, Yale University School of Public Health, New Haven, CT, USA.
| | - Lifang Jiang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
| | - Yue Ba
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China; Yellow River Institute for Ecological Protection & Regional Coordinated Development, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Guoyu Zhou
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China; Yellow River Institute for Ecological Protection & Regional Coordinated Development, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
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10
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Blitz MJ, Gerber RP, Gulersen M, Shan W, Rausch AC, Prasannan L, Meirowitz N, Rochelson B. Preterm birth among women with and without severe acute respiratory syndrome coronavirus 2 infection. Acta Obstet Gynecol Scand 2021; 100:2253-2259. [PMID: 34546577 PMCID: PMC8652761 DOI: 10.1111/aogs.14269] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Studies directly comparing preterm birth rates in women with and without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are limited. Our objective was to determine whether preterm birth was affected by SARS-CoV-2 infection within a large integrated health system in New York with a universal testing protocol. MATERIAL AND METHODS This retrospective cohort study evaluated data from seven hospitals in New York City and Long Island between March 2020 and June 2021, incorporating both the first and second waves of the coronavirus disease 2019 (COVID-19) pandemic in the USA. All patients with live singleton gestations who had SARS-CoV-2 polymerase chain reaction (PCR) testing at delivery were included. Deliveries before 20 weeks of gestation were excluded. The rate of preterm birth (before 37 weeks) was compared between patients with positive and negative SARS-CoV-2 test results. This analysis was performed separately for resolved prenatal infections and infections at delivery, with the latter group subdivided by symptom status. Multiple logistic regression analysis was used to examine the association between SARS-CoV-2 infection and preterm birth, adjusting for maternal age, race-ethnicity, parity, history of preterm birth, body mass index, marital status, insurance type, medical co-morbidities, month of delivery, and wave of pandemic. RESULTS A total of 31 550 patients were included and 2473 (7.8%) had laboratory-confirmed infection. Patients with symptomatic COVID-19 at delivery were more likely to deliver preterm (19.0%; adjusted odds ratio 2.76, 95% CI 1.92-3.88) compared with women with asymptomatic infection (8.8%) or without infection (7.1%). Among preterm births associated with symptomatic infection, 72.5% were medically indicated compared with 44.1% among women without infection (p < 0.001). Risk of preterm birth in patients with resolved prenatal infection was unchanged when compared with women without infection. Among women with infection at delivery, preterm birth occurred more frequently during the second wave compared with the first wave (13.6% vs. 8.7%, respectively; p < 0.006). However, this was not significant on multiple regression analysis after adjusting for other explanatory variables. CONCLUSIONS Pregnant women with symptomatic COVID-19 are more than twice as likely to have a preterm delivery than patients without infection. Asymptomatic infection and resolved prenatal infection are not associated with increased risk.
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Affiliation(s)
- Matthew J Blitz
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.,Institute of Health Systems Science, Feinstein Institutes for Medical Research, New York, USA
| | - Rachel P Gerber
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Moti Gulersen
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Weiwei Shan
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.,Biostatistics Unit, Feinstein Institutes for Medical Research, New York, USA
| | - Andrew C Rausch
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Lakha Prasannan
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Natalie Meirowitz
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Burton Rochelson
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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11
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Caniglia EC, Abrams J, Diseko M, Mayondi G, Mabuta J, Makhema J, Mmalane M, Lockman S, Bernstein A, Zash R, Shapiro R. Seasonality of adverse birth outcomes in women with and without HIV in a representative birth outcomes surveillance study in Botswana. BMJ Open 2021; 11:e045882. [PMID: 34479931 PMCID: PMC8420660 DOI: 10.1136/bmjopen-2020-045882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 08/05/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Sub-Saharan Africa has the largest number of people with HIV, one of the most severe burdens of adverse birth outcomes globally and particular vulnerability to climate change. We examined associations between seasonality and adverse birth outcomes among women with and without HIV in a large geographically representative birth outcomes surveillance study in Botswana from 2015 to 2018. METHODS We evaluated stillbirth, preterm delivery, very preterm delivery, small for gestational age (SGA), very SGA, and combined endpoints of any adverse or severe birth outcome. We estimated the risk of each outcome by month and year of delivery, and adjusted risks ratios (ARRs) of outcomes during the early wet (1 November-15 January), late wet (16 January-31 March) and early dry (1 April-15 July) seasons, compared with the late dry (16 July-31 October) season. Analyses were conducted overall and separately by HIV status. RESULTS Among 73 178 women (24% with HIV), the risk of all adverse birth outcomes peaked in November-January and reached low points in September. Compared with the late dry season, the ARRs for any adverse birth outcome were 1.03 (95% CI 1.00 to 1.06) for the early dry season, 1.08 (95% CI 1.04 to 1.11) for the early wet season and 1.07 (95% CI 1.03 to 1.10) for the late wet season. Comparing the early wet season to the late dry season, we found that ARRs for stillbirth and very preterm delivery were higher in women with HIV (1.23, 95% CI 0.96 to 1.59, and 1.33, 95% CI 1.10 to 1.62, respectively) than in women without HIV (1.07, 95% CI 0.91 to 1.26, and 1.19, 95% CI 1.04 to 1.36, respectively). CONCLUSIONS We identified a modest association between seasonality and adverse birth outcomes in Botswana, which was greatest among women with HIV. Understanding seasonal patterns of adverse birth outcomes and the role of HIV status may allow for mitigation of their impact in the face of seasonal extremes related to climate change.
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Affiliation(s)
- Ellen C Caniglia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jasmyn Abrams
- Department of Population Health, NYU Langone Health, New York, New York, USA
| | - Modiegi Diseko
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Gloria Mayondi
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Judith Mabuta
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Joseph Makhema
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Mompati Mmalane
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Shahin Lockman
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Infectious Disease, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Aaron Bernstein
- Immunology and Infectious Diseases, Center for Climate, Health, and the Global Environment, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Rebecca Zash
- Department of Infectious Diseases, BIDMC, Boston, Massachusetts, USA
| | - Roger Shapiro
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
- Immunology and Infectious Diseases, Center for Climate, Health, and the Global Environment, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
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12
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Megaw L, Clemens T, Daras K, Weller RB, Dibben C, Stock SJ. Higher Sun Exposure in the First Trimester Is Associated With Reduced Preterm Birth; A Scottish Population Cohort Study Using Linked Maternity and Meteorological Records. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:674245. [PMID: 36304023 PMCID: PMC9580751 DOI: 10.3389/frph.2021.674245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Preterm birth (birth at <37 weeks gestation) is the leading cause of death in children under 5-years-old, and prevention is a global public health issue. Seasonal patterns of preterm birth have been reported, but factors underlying this have been poorly described. Sun exposure is an important environmental variable that has risks and benefits for human health, but the effects of sun exposure on pregnancy duration and preterm birth are unknown. Objectives: To determine the association between available sun exposure and preterm birth. Methods: We performed a population-based data-linkage study of 556,376 singleton births (in 397,370 mothers) at or after 24 weeks gestation, in Scotland between 2000 and 2010. Maternity records were linked to available sun exposure from meteorological records, by postcode. Logistic regression analysis was used to explore the relationship between available sunshine and preterm birth at <37 weeks gestation. Exploratory analyses included a subgroup analysis of spontaneous and indicated preterm births and a sibling analysis in sib pairs discordant for preterm birth. Results: The rate of preterm birth was 6% (32,958/553,791 live births). Increased available sun exposure in the first trimester of pregnancy was associated with a reduced risk of preterm birth, with evidence of a dose-response. Compared with the lowest quartile of sun exposure, the highest quartile of sun exposure was associated with a reduced odds ratio (OR) of preterm birth of 0.90 (95% Confidence Interval (CI) 0.88-0.94 p < 0.01) on univariable analysis and OR of 0.91 (95% CI 0.87, 0.93 p < 0.01) after adjustment for second trimester sunlight exposure, parity, maternal age, smoking status, and deprivation category. No association was seen between preterm birth and second trimester available sun exposure or combined first and second trimester exposure. Similar patterns were seen on sibling analysis and within both the indicated and spontaneous preterm subgroups. Discussion: Available sun exposure in the first trimester of pregnancy is associated with a protective effect on preterm birth <37 weeks gestation. This opens up new mechanisms, and potential therapeutic pathways, for preterm birth prevention.
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Affiliation(s)
- Lauren Megaw
- Tommy's Centre for Maternal and Fetal Health, Medical Research Council Centre for Reproductive Health, University of Edinburgh Queen's Medical Research Institute, Edinburgh, United Kingdom
- School of Women and Infants Health, University of Western Australia, Perth, WA, Australia
| | - Tom Clemens
- School of Geosciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Konstantinos Daras
- Institute of Population Health Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Richard B. Weller
- Centre for Inflammation Research, University of Edinburgh Queen's Medical Research Institute, Edinburgh, United Kingdom
| | - Chris Dibben
- School of Geosciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Sarah Jane Stock
- Tommy's Centre for Maternal and Fetal Health, Medical Research Council Centre for Reproductive Health, University of Edinburgh Queen's Medical Research Institute, Edinburgh, United Kingdom
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
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Salama E EIAS, Salama HS, Alobaidly SH. Socioeconomic Risk Factors for Preterm Birth in the state of Qatar: A Population-based Study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021186. [PMID: 34212910 PMCID: PMC8343749 DOI: 10.23750/abm.v92i3.11292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 11/29/2022]
Abstract
Objectives: To review the demographics and socioeconomic determinants of preterm birth (PTB) compared to term births among the Qatari population. Methods: This was a retrospective data analysis of 59,308 births. Data were retrieved from a Population-based Cohort Study. Data were gathered from the PEARL-Peristat maternal newborn registry for 2011, 2012, 2017, and 2018. We compared the preterm births group (delivery < 37 weeks) with the term group (delivery ≥ 37 weeks) regarding socioeconomic factors, including maternal nationality, religion, level of education, mother’s occupation, family income, housing, consanguinity, early childbearing, high-risk pregnancy, smoking, assisted conception, antenatal care, and place of delivery. Results: The prevalence of preterm birth was 9%. There were more Saudi nations in the preterm group compared to term (33% vs. 28%, p-value < 0.001). There were more preterm births than term births among working mothers (40% vs. 35%), high-risk pregnancies (24% vs. 18%), those that has used assisted conception (18% vs. 3%), those without antenatal care (11% vs. 5.6%), and those delivered in a tertiary women hospital (88.5% vs. 84.5%) (all p-values < 0.001). There were more women living in villas (41% vs. 38%, p = 0.01) and more smokers (0.8% vs. 0.5%, p = 0.030) in the preterm group than in the term group. There were no differences between the two groups regarding religion, level of maternal education, family income, and early childbearing. Conclusion: In our population, we identified several factors associated with preterm births. (www.actabiomedica.it)
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Marques-Fernandez L, Sharma S, Mannu U, Chong HP. Impact of Covid-19 on attendances for a 1st episode of reduced fetal movements: A retrospective observational study. PLoS One 2021; 16:e0253796. [PMID: 34170973 PMCID: PMC8232461 DOI: 10.1371/journal.pone.0253796] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/11/2021] [Indexed: 12/04/2022] Open
Abstract
Background Prior studies have demonstrated an increased stillbirth rate. It was suggested that the COVID-19 pandemic may have impacted on attendances for reduced fetal movements. Thus, we sought to ascertain the impact of the pandemic on attendances for reduced fetal movements (RFM) in our unit, ultrasound provision for reduced fetal movements, and the stillbirth rate. Methods This was a single site retrospective cohort study involving all women complaining of a 1st episode of reduced fetal movements between 01/03/2020-30/04/2020 (COVID) to 01/03/2019-30/04/2019 (Pre-COVID). Data were retrieved from computerised hospital records and statistical analyses were performed using GraphPad Prism and SPSS. Results 22% (179/810) of women presented with a 1st episode of reduced fetal movements Pre-COVID compared to 18% (145/803) during COVID (p = 0.047). Primiparous women were significantly over-represented in this population with a 1.4-fold increase in attendances during COVID (67% vs 48%, p = 0.0005). Neither the total stillbirth rate nor the stillbirth rate amongst women who presented with reduced fetal movements changed during COVID. Ultrasound provision was not impacted by COVID with 95% of the scans performed according to local guidelines, compared to Pre-COVID (74%, p = 0.0001). Conclusions There is a significant decrease in 1st attendances for reduced fetal movements during COVID-19 pandemic. Primiparous women were 1.4 times more likely to attend with RFM. Women should be reassured that COVID-19 has not resulted in a decreased provision of care for RFM, and has not impacted on the stillbirth rate.
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Affiliation(s)
- Laia Marques-Fernandez
- Department of Obstetrics and Gynaecology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, United Kingdom
- * E-mail:
| | - Swati Sharma
- Department of Obstetrics and Gynaecology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, United Kingdom
| | - Una Mannu
- Department of Obstetrics and Gynaecology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, United Kingdom
| | - Hsu Phern Chong
- Department of Obstetrics and Gynaecology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, United Kingdom
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The Association between Preterm Birth and Ambient Air Pollution Exposure in Shiyan, China, 2015-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084326. [PMID: 33921784 PMCID: PMC8072601 DOI: 10.3390/ijerph18084326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 11/17/2022]
Abstract
Shortening of the gestational duration has been found associated with ambient air pollution exposure. However, the critical exposure windows of ambient air pollution for gestational duration remain inconsistent, and the association between ambient air pollution and early term births (ETB, 37 to 38 weeks) has rarely been studied relative to preterm births (PTB, 28–37 weeks). A time-series study was conducted in Shiyan, a medium-sized city in China. Birth information was collected from the Shiyan Maternity and Child Health Hospital, and 13,111 pregnant women who gave birth between 2015 and 2017 were included. Data of the concentrations of air pollutants, including PM10, PM2.5, NO2, and SO2 and meteorological data, were collected in the corresponding gestational period. The Cox regression analysis was performed to estimate the relationship between ambient air pollution exposure and the risk of preterm birth after controlling the confounders, including maternal age, education, Gravidity, parity, fetal gender, and delivery mode. Very preterm birth (VPTB, 28–32 weeks) as a subtype of PTB was also incorporated in this study. The risk of VPTB and ETB was positively associated with maternal ambient air pollution exposure, and the correlation of gaseous pollutants was stronger than particulate matter. With respect to exposure windows, the critical trimester of air pollutants for different adverse pregnancy outcomes was different. The exposure windows of PM10, PM2.5, and SO2 for ETB were found in the third trimester, with HRs (hazard ratios) of 1.06 (95%CI: 1.04, 1.09), 1.07 (95%CI: 1.04, 1.11), and 1.28 (95%CI: 1.20, 1.35), respectively. However, for NO2, the second and third trimesters exhibited similar results, the HRs reaching 1.10 (95%CI: 1.03, 6.17) and 1.09 (95%CI: 1.03,1.15), respectively. This study extends and strengthen the evidence for a significant correlation between the ambient air pollution exposure during pregnancy and the risk of not only PTB but, also, ETB. Moreover, our findings suggest that the exposure windows during pregnancy vary with different air pollutants and pregnancy outcomes.
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16
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Miłkowska K, Nenko I, Klimek M, Galbarczyk A, Jasienska G. Season of birth and biomarkers of early-life environment. Am J Hum Biol 2020; 33:e23532. [PMID: 33166028 DOI: 10.1002/ajhb.23532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/21/2020] [Accepted: 10/22/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Early-life conditions play an important role in human development, affecting health status and survival. Conditions in utero partly depend on the external environment and thus vary in relation to the season of birth. The aim of this study was to investigate if people born in different seasons of the year differ in values of biomarkers that reflect conditions during fetal development. METHODS The study was conducted among Polish rural women recruited at the Mogielica Human Ecology Study Site. The participants were 234 women aged 45 to 92 (mean = 60.2; SD = 10.44). The indicators of early-life environment analyzed in the study were: Absolute Finger Ridge Count (AFRC), the difference between mean number of ridge counts in both thumbs and both little fingers (Md15), overall facial fluctuating asymmetry (OFA), central facial asymmetry (CFA), right and left hand 2D:4D. RESULTS Values of biomarkers of fetal development did not vary among groups of women born in different seasons of the year. CONCLUSIONS Lack of differences in values of biomarkers according to birth season may indicate that: (a) season of birth is not a good indicator of early-life conditions; (b) tested biomarkers do not reliably reflect the prenatal environment; (c) season of birth does not fully overlap with the sensitive periods of biomarker development and thus fails to capture differences in developmental conditions.
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Affiliation(s)
- Karolina Miłkowska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Ilona Nenko
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Klimek
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Andrzej Galbarczyk
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
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17
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Dunlop AL, Joski P, Strahan AE, Sierra E, Adams EK. Postpartum Medicaid Coverage and Contraceptive Use Before and After Ohio's Medicaid Expansion Under the Affordable Care Act. Womens Health Issues 2020; 30:426-435. [PMID: 32958368 DOI: 10.1016/j.whi.2020.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/10/2020] [Accepted: 08/19/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Ensuring that women with Medicaid-covered births retain coverage beyond 60 days postpartum can help women to receive care that will improve their health outcomes. Little is known about the extent to which the Affordable Care Act (ACA) Medicaid expansion has allowed for longer postpartum coverage as more women entering Medicaid under a pregnancy eligibility category could now become income eligible. This study investigates whether Ohio's Medicaid expansion increased continuous enrollment and use of covered services postpartum, including postpartum visit attendance, receipt of contraceptive counseling, and use of contraceptive methods. METHODS We used Ohio's linked Medicaid claims and vital records data to derive a study cohort whose prepregnancy and 6-month postpartum period occurred fully in either before (January 2011 to June 2013) or after (November 2014 to December 2015) the ACA Medicaid expansion implementation period (N = 170,787 after exclusions). We categorized women in this cohort according to whether they were pregnancy eligible (the treatment group) or income eligible (the comparison group) as they entered Medicaid and used multivariate logistic regression to test for differences in the association of the ACA expansion with their postpartum enrollment in Medicaid and use of services. RESULTS Women who entered Ohio Medicaid in the pregnancy eligible category had a 7.7 percentage point increase in the probability of remaining continuously enrolled 6 months postpartum relative to those entering as income eligible. Income eligible women had approximately a 5.0 percentage point increased likelihood of both a postpartum visit and use of long-acting reversible contraceptives. Pregnancy-eligible women had a significant but smaller (approximately 2 percentage point) increase in the likelihood of long-acting reversible contraceptive use. CONCLUSIONS Ohio's ACA Medicaid expansion was associated with a significant increase in the probability of women's continuous enrollment in Medicaid and use of long-acting reversible contraceptives through 6 months postpartum. Together, these changes translate into decreased risks of unintended pregnancy and short interpregnancy intervals.
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Affiliation(s)
- Anne L Dunlop
- Emory University Nell Hodgson Woodruff School of Nursing, Emory University School of Medicine, Atlanta, Georgia
| | - Peter Joski
- Department of Health Policy and Management, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Andrea E Strahan
- Department of Health Policy and Management, Emory University Rollins School of Public Health, Atlanta, Georgia
| | | | - E Kathleen Adams
- Department of Health Policy and Management, Emory University Rollins School of Public Health, Atlanta, Georgia.
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18
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Freedman AA, Goldstein JA, Miller GE, Borders A, Keenan-Devlin L, Ernst LM. Seasonal Variation of Chronic Villitis of Unknown Etiology. Pediatr Dev Pathol 2020; 23:253-259. [PMID: 31821774 DOI: 10.1177/1093526619892353] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Chronic villitis of unknown etiology (VUE) is a chronic inflammatory lesion of the placenta. VUE is hypothesized to result from an alloimmune response or as response to an unidentified infection. Lack of a seasonal trend is thought to support VUE as an alloimmune response, though data on seasonal VUE trends are limited. METHODS Data were obtained from a hospital in Chicago, Illinois, from 2011-2016. Placentas sent to pathology were reviewed using a standardized protocol, and VUE cases were identified based on an automated text search of pathology records. We used monthly VUE prevalence estimates to investigate the annual trend, and we used Poisson regression to evaluate seasonal variation in the number of VUE cases. RESULTS There were 79 825 deliveries within the study period. Pathologists evaluated 12 074 placentas and identified 2873 cases of VUE. Regression results indicate that the risk of VUE is 16% to 17% higher in the fall and winter as compared to the summer (fall relative risk [RR]: 1.17, 95% confidence interval [CI]: 1.06-1.29; winter RR: 1.16, 95% CI: 1.05-1.29). DISCUSSION Our results suggest that there may be seasonal variation in VUE prevalence, particularly for low-grade VUE. Future studies should evaluate seasonal variation in a representative sample rather than relying on pathology reports to estimate prevalence.
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Affiliation(s)
- Alexa A Freedman
- Institute for Policy Research, Northwestern University, Evanston, Illinois.,Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, Illinois
| | - Jeffery A Goldstein
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Gregory E Miller
- Institute for Policy Research, Northwestern University, Evanston, Illinois.,Department of Psychology, Northwestern University, Evanston, Illinois
| | - Ann Borders
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, Evanston, Illinois
| | - Lauren Keenan-Devlin
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, Evanston, Illinois
| | - Linda M Ernst
- Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, Evanston, Illinois
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Majeed MT, Ozturk I. Environmental degradation and population health outcomes: a global panel data analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:15901-15911. [PMID: 32100215 DOI: 10.1007/s11356-020-08167-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/19/2020] [Indexed: 06/10/2023]
Abstract
This study investigates the relationship between environmental degradation and population health using a global panel data of 180 countries from 1990 to 2016. The empirical analysis is conducted using fixed-effects approach based on Hausman test. Moreover, two-stage least squares (2SLS) and system-generalized method of moments (SGMM) are used to deal with the endogenous nature of environmental degradation. The indicators of life expectancy and infant mortality are used to measure population health, whereas environmental degradation is measured by CO2 emissions. The empirical findings show that environmental degradation negatively influences population health outcomes. It implies that countries having a high level of environmental degradation experience low life expectancy and high infant mortality rates. Findings of the study suggest that health-related reforms need to be aligned with policies which ensure lower environmental degradation.
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Affiliation(s)
| | - Ilhan Ozturk
- Faculty of Economics and Administrative Sciences, Cag University, Mersin, Turkey.
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
- Department of Finance, Asia University, 500, Lioufeng Rd., Wufeng, Taichung, 41354, Taiwan.
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20
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Monier I, Baptiste A, Tsatsaris V, Senat MV, Jani J, Jouannic JM, Winer N, Elie C, Souberbielle JC, Zeitlin J, Benachi A. First Trimester Maternal Vitamin D Status and Risks of Preterm Birth and Small-For-Gestational Age. Nutrients 2019; 11:nu11123042. [PMID: 31847068 PMCID: PMC6950733 DOI: 10.3390/nu11123042] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/22/2019] [Accepted: 12/06/2019] [Indexed: 12/13/2022] Open
Abstract
Maternal 25-hydroxyvitamin D (25-OHD) deficiency during pregnancy may increase the risk of preterm and small-for-gestational age (SGA) birth, but studies report conflicting results. We used a multicenter prospective cohort of 2813 pregnant women assessed for 25-OHD levels in the first trimester of pregnancy to investigate the association between maternal 25-OHD concentrations and risks of preterm birth (<37 weeks) and SGA (birthweight <10th percentile). Odds ratios were adjusted (aOR) for potential cofounders overall and among women with light and dark skin separately, based on the Fitzpatrick scale. 25-OHD concentrations were <20 ng/mL for 45.1% of the cohort. A total of 6.7% of women had a preterm birth. The aOR for preterm birth associated with the 1st quartile of 25-OHD concentrations compared to the 4th quartile was 1.53 (95% confidence interval (CI): 0.97–2.43). In stratified analyses, an association was observed for women with darker skin (aOR = 2.89 (95% CI: 1.02–8.18)), and no association with lighter skin. A total of 11.9% of births were SGA and there was no association overall or by skin color. Our results do not provide support for an association between maternal first trimester 25-OHD deficiency and risk of preterm or SGA birth overall; the association with preterm birth risk among women with darker skin requires further investigation.
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Affiliation(s)
- Isabelle Monier
- Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France;
- Department of Obstetrics and Gynaecology, Antoine Béclère Hospital, AP-HP, University Paris Saclay, F-92140 Clamart, France;
- Correspondence: ; Tel.: +33-(0)1-7172-2992
| | - Amandine Baptiste
- URC/CIC Paris Descartes Necker Cochin, Necker-Enfants Malades Hospital, AP-HP, F-75015 Paris, France
| | - Vassilis Tsatsaris
- Department of Obstetrics, Cochin Hospital, AP-HP, Paris-Descartes University, F-75014 Paris, France
| | - Marie-Victoire Senat
- Department of Obstetrics and Gynecology, Bicêtre Hospital, AP-HP, Université Paris Saclay, F-94270 Kremlin Bicêtre, France
| | - Jacques Jani
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, B-1000 Brussels, Belgium
| | - Jean-Marie Jouannic
- Fetal Medecine Department, Armand Trousseau Hospital, AP-HP, UPMC-Sorbonne Université, F-75012 Paris, France
| | - Norbert Winer
- Department of Obstetrics and Gynecology, University Hospital of Nantes, CIC Mere enfant Nantes, NUN, INRA, UMR 1280, Phan, Nantes University, F-44000 Nantes, France
| | - Caroline Elie
- URC/CIC Paris Descartes Necker Cochin, Necker-Enfants Malades Hospital, AP-HP, F-75015 Paris, France
| | - Jean-Claude Souberbielle
- Laboratoire d’Explorations Fonctionnelles, Necker-Enfants malades Hospital, AP-HP, F-75015 Paris, France
| | - Jennifer Zeitlin
- Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France;
| | - Alexandra Benachi
- Department of Obstetrics and Gynaecology, Antoine Béclère Hospital, AP-HP, University Paris Saclay, F-92140 Clamart, France;
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Miao H, Li B, Li W, Yao F, Chen Y, Chen R, Lin J, Wu Y, Guo P, Zhao Q. Adverse birth outcomes in Guangdong province, China, 2014-2017: a spatiotemporal analysis of 2.9 million births. BMJ Open 2019; 9:e030629. [PMID: 31727652 PMCID: PMC6886959 DOI: 10.1136/bmjopen-2019-030629] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Adverse birth outcomes pose a great threat to the public health and bring a heavy burden of disease in China. A comprehensive examination of the temporal and spatial trends of preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA) epidemics can provide some elementary information for subsequent aetiological and epidemiological studies. This study aimed to characterise the spatiotemporal features of PTB, LBW and SGA based on a large cohort of live births in China. DESIGN Spatiotemporal descriptive analysis was performed in Guangdong province, China, from 2014 to 2017. SETTING Data involving 2 917 098 live births in Guangdong province, China from 2014 to 2017 was collected from Guangdong Birth Certificate System. Information was collected, including the date of birth, gestational age in week, birth weight, sex of the infant, age of the mother and registered residence of the mother. RESULTS The estimated rate of PTB, LBW and SGA was 4.16%, 4.14% and 12.86%, respectively. For temporal trends, the rates of PTB, LBW and SGA showed seasonal fluctuations, especially for LBW and SGA. In addition, there were regional differences in the rates of PTB, LBW and SGA between the Pearl River Delta and Non-Pearl River Delta regions. From 2014 to 2017, the high rates of PTB and LBW expanded from the Pearl River Delta region to the Non-Pearl River Delta regions. However, compared with the Pearl River Delta region, the rate of SGA was higher in the Non-Pearl River Delta regions on the whole. CONCLUSION The findings of this study contribute to the understanding of the aetiology and epidemiology of PTB, LBW and SGA in south China.
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Affiliation(s)
- Huazhang Miao
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Bing Li
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Wu Li
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Fei Yao
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Yuliang Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Ruyin Chen
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Jiumin Lin
- Department of Hepatology and Infectious Diseases, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Yuntao Wu
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Qingguo Zhao
- Epidemiological Research Office of Key Laboratory of Male Reproduction and Genetics (National Health Commission of PRC), Family Planning Special Hospital of Guangdong Province, Guangzhou, China
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22
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Karlsson H, Dal H, Gardner RM, Torrey EF, Dalman C. Birth month and later diagnosis of schizophrenia. A population-based cohort study in Sweden. J Psychiatr Res 2019; 116:1-6. [PMID: 31170611 DOI: 10.1016/j.jpsychires.2019.05.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/10/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
Abstract
The objective of the present study was to examine if the monthly variation in births of individuals diagnosed with schizophrenia currently differs from that of unaffected individuals in Sweden. In an extensive linkage of Swedish national and regional population registers we here investigate the birth pattern of the population born 1940-97 (5,995,499 individuals) which included 30,684 individuals diagnosed with schizophrenia in the National Patient Register by December 31, 2016. Among 2,409,862 individuals born since 1973 we investigated potential confounding by co-variates associated with pregnancy and birth. We also compared the monthly birth pattern of 22,570 affected individuals to that of their 41,528 unaffected full siblings. We observe a significant birth excess of individuals with schizophrenia in December, HR 1.07 95%CI (1.01-1.13). Patients born in December received a registered diagnosis of schizophrenia at a slightly younger age than those born during other months. A number of co-variates were associated not only with schizophrenia but also varied across birth months. Inclusion of these in the models however had virtually no influence on the risk for schizophrenia associated with December birth. In comparisons between full siblings, the association between December birth and later diagnosis of schizophrenia remained, albeit slightly attenuated, HR 1.06 (0.99-1.12). Risk for schizophrenia associated with birth in December in Sweden during the study period does not appear to be fully explained by our investigated co-variates or factors shared between family members and may thus represent monthly/seasonal variation in environmental factors involved in the etiology of schizophrenia.
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Affiliation(s)
- Hakan Karlsson
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Henrik Dal
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Renee M Gardner
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | - Christina Dalman
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Yu X, Feric Z, Cordero JF, Meeker JD, Alshawabkeh A. Potential influence of temperature and precipitation on preterm birth rate in Puerto Rico. Sci Rep 2018; 8:16106. [PMID: 30382121 PMCID: PMC6208375 DOI: 10.1038/s41598-018-34179-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 10/12/2018] [Indexed: 11/21/2022] Open
Abstract
The preterm birth (PTB) rate for singletons born in the tropical Caribbean island Puerto Rico increased from 11.3% in 1994, which was comparable to rates in the U.S., to as high as 18.3% in 2006 before decreasing to 15.5% in 2012. A few studies have reported that weather extremes are associated with higher risk of preterm birth, however, the effects of ambient temperature and precipitation has not been well examined in Puerto Rico. We compiled child birth data from the National Center for Health Statistics and weather data from the National Oceanic and Atmospheric Administration from 1994 to 2012. We explored the association between the weather factors and PTB rates with a distributed lag non-linear model (DLNM). We did not find direct association of lagged effect of temperature on birth outcome over monthly timescales. Both high intensity and frequency of precipitation and high frequency of storm and flood events are associated with increased risk of PTB rates. While the weather factors do not explain the marked increase and decrease in PTB rate, we emphasize the negative effects on PTB from weather extremes particularly precipitation in Puerto Rico.
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Affiliation(s)
- Xue Yu
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Zlatan Feric
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA
| | - José F Cordero
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA
| | - John D Meeker
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Akram Alshawabkeh
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA.
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Weng YH, Yang CY, Chiu YW. Adverse neonatal outcomes in relation to ambient temperatures at birth: A nationwide survey in Taiwan. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2018; 73:48-55. [PMID: 28409661 DOI: 10.1080/19338244.2017.1299084] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 02/19/2017] [Indexed: 06/07/2023]
Abstract
This study investigated the temperature-specific risks of adverse neonatal outcomes in Taiwan. Over 2 million births between 2001 and 2010 were correlated with the daily mean outdoor temperatures at birth. A log-binomial model was used to estimate the risk of adverse neonatal outcomes in relation to ambient temperature at birth after adjusting for possible confounders. There was a significant correlation of temperature extremes with stillbirth, preterm birth, and low birth weight. Maternal exposure to temperature extremes carried greater risks of stillbirth (> 23.4°C), preterm birth (< 19.5°C and > 25.4°C), and low birth weight (< 15.5°C and > 23.4°C) than did temperatures of 21.5°C∼23.4°C. In conclusion, infants born to women exposed to temperature extremes possess greater risks for stillbirth, preterm birth, and low birth weight. The data suggest optimal temperatures to minimize overall adverse neonatal outcomes are 21.5°C∼23.4°C.
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Affiliation(s)
- Yi-Hao Weng
- a Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital , Chang Gung University College of Medicine , Taipei , Taiwan
| | - Chun-Yuh Yang
- b Department of Public Health , Kaohsiung Medical University , Kaohsiung , Taiwan
| | - Ya-Wen Chiu
- c Master Program in Global Health and Development, Health Policy and Care Research Center, College of Public Health , Taipei Medical University , Taipei , Taiwan
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Muresan D, Staicu A, Zaharie G, Marginean C, Rotar IC. The influence of seasonality and weather changes on premature birth incidence. ACTA ACUST UNITED AC 2017; 90:273-278. [PMID: 28781523 PMCID: PMC5536206 DOI: 10.15386/cjmed-744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 11/28/2016] [Indexed: 12/18/2022]
Abstract
Background Although the effects of meteorological factors on the general population health are widely documented, little is known about their influence on human pregnancy and birth. The present study aims at analyzing the influence of the atmospheric conditions on premature births. Method One hundred and eight nine cases of premature births were included in the study, with a gestational age between 24 to 37 weeks of amenorrhea. Cases with antepartum fetal death and those with uncertain gestational age have been excluded. Daily weather data were obtained using http://www.wunderground.com site. A Pearson’s product-moment correlation was run to assess the relationship between weekly preterm birth incidence and the total number of premature births and the mean maximum and minimum temperature (Tmax, Tmin), maximum and minimum average humidity (Umax, Umin), maximum and minimum atmospheric pressure mean (P max, P min), average wind speed and average quantity precipitations, calculated for one calendar week. Results Approximately 7.7% of all births during the study period occurred before 37 weeks of gestation, the main reason for hospitalization being premature rupture of membranes (45%). The analysis revealed a moderate positive correlation between weekly preterm birth incidence and the average temperature (r=0.306, n=52, p=0.027) and a moderate positive correlation between weekly preterm birth incidence and temperature variation (r=0.307, n=52, p=0.007). Our study found no significant statistic correlation between the humidity variation, pressure variation, and wind speed. Conclusions The incidence of premature births can be influenced by variations of specific weather factors, especially during the weeks characterized by large fluctuations in temperature. The results obtained might inspire the construction of multicenter studies to investigate more thoroughly the adverse effects of some meteorological factors that can influence the outcomes of human pregnancy.
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Affiliation(s)
- Daniel Muresan
- 1 Obstetrics and Gynecology Department, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Adelina Staicu
- 1 Obstetrics and Gynecology Department, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Gabriela Zaharie
- Neonatology Department, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Claudiu Marginean
- Department of Obstetrics and Gynecology I, University of Medicine and Pharmacy of Targu Mures, Romania
| | - Ioana Cristina Rotar
- 1 Obstetrics and Gynecology Department, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Romania
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Gluck O, Mizrachi Y, Leytes S, Bar J, Kovo M. Was the Military Operation "Protective Edge" a Risk Factor for Pregnancy Complications? Rambam Maimonides Med J 2017; 8:RMMJ.10304. [PMID: 28467766 PMCID: PMC5415373 DOI: 10.5041/rmmj.10304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE During July-August 2014, the military operation "Protective Edge" presented Israel with a threat of missile attacks. We aimed to investigate the influence of the "Protective Edge" operation on the rate of pregnancy complications among the population exposed to missile attacks, compared to the population not exposed. STUDY DESIGN This was a retrospective study. Pregnancy outcomes were compared between women who during pregnancy were exposed to the stress of the military operation (exposed group, n=4,673) and gave birth at the Wolfson Medical Center, and women who gave birth in the previous year (unexposed group, n=4,735). RESULTS Rates of pregnancy complications did not differ between the groups. CONCLUSION Exposure to environmental stress during pregnancy, for a period of almost two months, was not found to be associated with increased risk for pregnancy complications.
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Affiliation(s)
- Ohad Gluck
- Department of Obstetrics and Gynecology, E. Wolfson Medical Center, Holon, Israel, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yossi Mizrachi
- Department of Obstetrics and Gynecology, E. Wolfson Medical Center, Holon, Israel, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sophia Leytes
- Department of Obstetrics and Gynecology, E. Wolfson Medical Center, Holon, Israel, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jacob Bar
- Department of Obstetrics and Gynecology, E. Wolfson Medical Center, Holon, Israel, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Kovo
- Department of Obstetrics and Gynecology, E. Wolfson Medical Center, Holon, Israel, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Grootendorst-van Mil NH, Steegers-Theunissen RPM, Hofman A, Jaddoe VWV, Verhulst FC, Tiemeier H. Brighter children? The association between seasonality of birth and child IQ in a population-based birth cohort. BMJ Open 2017; 7:e012406. [PMID: 28213594 PMCID: PMC5318550 DOI: 10.1136/bmjopen-2016-012406] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Season of birth has repeatedly been found to be a risk indicator for adverse neurodevelopmental outcomes. Several explanations for this finding have been put forward but no conclusion has been reached. In the current study, we explored the role of sociodemographic and biological factors in the association between season of birth and child IQ. DESIGN In a prenatally recruited birth cohort (born in 2002-2006), we examined the association between season of birth and non-verbal IQ at age 6 years among 6034 children. We explored how adjusting for socioeconomic status and maternal IQ, childbirth outcomes, pregnancy vitamin D status, nutritional intake, exposure to infections, and child age relative to peers in class changed the relation between season of birth and child IQ. RESULTS We found that spring birth was associated with lower non-verbal IQ (estimate: more than 1 point; β-1.24 (95% CI -2.31 to -0.17), p=0.02; seasonal trend β-0.40 (95% CI -0.74 to -0.07), p=0.02) than birth in summer. Adjustment for different covariates led to a substantial reduction (-65.0% change, in a seasonal trend analysis) of this association. In particular, sociodemographic factors and maternal IQ (-10.0% and -22.5% change, respectively) contributed. CONCLUSIONS Season of birth is an indicator of many underlying factors related to child IQ. The observed effects on IQ were small and therefore not of clinical significance.
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Affiliation(s)
- Nina H Grootendorst-van Mil
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Régine P M Steegers-Theunissen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Woo Y, Ouh YT, Ahn KH, Cho GJ, Hong SC, Oh MJ, Kim HJ. Seasonal Pattern of Preterm Births in Korea for 2000-2012. J Korean Med Sci 2016; 31:1797-1801. [PMID: 27709859 PMCID: PMC5056213 DOI: 10.3346/jkms.2016.31.11.1797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 08/13/2016] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to investigate a seasonal pattern of preterm births in Korea. Data were obtained from the national birth registry of the Korean Statistics Office and included all births in Korea during the period 2000-2012 (n = 6,310,800). Delivery dates were grouped by month of the year or by season (winter [December, January, February], spring [March, April, May], summer [June, July, August], and autumn [September, October, November]). The seasonal patterns of prevalence of preterm births were assessed. The rates of preterm births at 37 weeks were highest twice a year (once in winter and again in summer). The rates of preterm births increased by 13.9% in summer and 7.5% in winter, respectively, than in spring (OR, 1.139; 95% CI, 1.127-1.152, and OR, 1.075; 95% 1.064-1.087, respectively) after controlling for age, the educational level of the parents, maternal parity, and neonatal gender. The pattern for spontaneous preterm births < 34 weeks was similar. In Korea, a seasonal pattern of preterm births was observed, with peak prevalence in summer and winter. A seasonal pattern of preterm births may provide new insights for the pathophysiology of preterm births.
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Affiliation(s)
- Yoonmi Woo
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yung Taek Ouh
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Ki Hoon Ahn
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
| | - Soon Cheol Hong
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Min Jeong Oh
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hai Joong Kim
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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Liang Z, Lin Y, Ma Y, Zhang L, Zhang X, Li L, Zhang S, Cheng Y, Zhou X, Lin H, Miao H, Zhao Q. The association between ambient temperature and preterm birth in Shenzhen, China: a distributed lag non-linear time series analysis. Environ Health 2016; 15:84. [PMID: 27503307 PMCID: PMC4977688 DOI: 10.1186/s12940-016-0166-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 07/24/2016] [Indexed: 05/18/2023]
Abstract
BACKGROUND A few studies have examined the association between ambient temperature and preterm birth (PTB), and the results have been inconsistent. This study explored the association between ambient temperature and PTB in Shenzhen, China. METHODS Data of daily singleton PTB, air pollution and meteorological variables from 2005 to 2011 were collected in Shenzhen. A distributed lag non-linear model (DLNM) was used to investigate the association of the low and high temperatures (1st, 5th, 95th, and 99th percentiles) with PTB. RESULTS The median temperature was 24.5 °C and the 1st, 5th, 95th, and 99th percentiles of daily mean temperatures were 9, 12.5, 29.9 and 30.7 °C, respectively. The prevalence of singleton PTB was 5.61 % in Shenzhen. The association between temperature and PTB was not linear. There was an immediate positive association of low temperature (1st and 5th percentiles) and a negative association of high temperature (95th and 99th percentiles) with PTB. The effect of low temperature 9 °C (1st) on PTB on the current day was stronger than that of 12.5 °C (5th), with a relative risk (RR) of 1.54 (95 % CI: 1.36-1.75) and 1.49 (95 % CI: 1.35-1.63), respectively. The cumulative RR (up to 30 days) of 9 and 12.5 °C was 1.72 (95 % CI: 1.28-2.33) and 1.96 (95 % CI: 1.60-2.39), respectively. The cumulative effects (up to 30 days) of high temperature (95th and 99th percentiles) on PTB were 0.69 (95 % CI: 0.60-0.80) and 0.62 (95 % CI: 0.52-0.74), respectively. The cumulative effect (up to 30 days) of low temperatures on vaginal delivery PTB was lower than that of the cesarean section PTB with an RR of 1.58 (95 % CI: 1.12-2.22) and 1.93 (95 % CI: 1.21-3.08), respectively. CONCLUSIONS This study suggests that low temperature might be a risk factor, while high temperature might be a protective factor of PTB in Shenzhen.
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Affiliation(s)
- Zhijiang Liang
- Department of Public Health, Guangdong Women And Children Hospital, 521, 523 Xing Nan Street, Panyu District, 511442 Guangzhou, Guangdong China
| | - Yan Lin
- Department of Children Health Care, Shenzhen Women and Children Hospital, Shenzhen, Guangdong China
| | - Yuanzhu Ma
- Department of Public Health, Guangdong Women And Children Hospital, 521, 523 Xing Nan Street, Panyu District, 511442 Guangzhou, Guangdong China
| | - Lei Zhang
- Department of Information Network, Meteorological Bureau of Shenzhen Municipality, Shenzhen, Guangdong China
| | - Xue Zhang
- Department of Public Health, Fu Tian Maternal and Children Health Hospital, Shenzhen, Guangdong China
| | - Li Li
- Department of Public Health, Luo Hu Maternal and Children Health Hospital, Shenzhen, Guangdong China
| | - Shaoqiang Zhang
- Department of Public Health, Long Gang Maternal and Children Health Hospital, Shenzhen, Guangdong China
| | - Yuli Cheng
- Department of Public Health, Bao An Maternal and Children Health Hospital, Shenzhen, Guangdong China
| | - Xiaomei Zhou
- Fu Tian Hospital of TCM, Shenzhen, Guangdong China
| | - Hualiang Lin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong China
| | - Huazhang Miao
- Department of Public Health, Guangdong Women And Children Hospital, 521, 523 Xing Nan Street, Panyu District, 511442 Guangzhou, Guangdong China
| | - Qingguo Zhao
- Department of Public Health, Guangdong Women And Children Hospital, 521, 523 Xing Nan Street, Panyu District, 511442 Guangzhou, Guangdong China
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Vazquez-Benitez G, Kharbanda EO, Naleway AL, Lipkind H, Sukumaran L, McCarthy NL, Omer SB, Qian L, Xu S, Jackson ML, Vijayadev V, Klein NP, Nordin JD. Risk of Preterm or Small-for-Gestational-Age Birth After Influenza Vaccination During Pregnancy: Caveats When Conducting Retrospective Observational Studies. Am J Epidemiol 2016; 184:176-86. [PMID: 27449414 DOI: 10.1093/aje/kww043] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 02/19/2016] [Indexed: 12/11/2022] Open
Abstract
Vaccines are increasingly targeted toward women of reproductive age, and vaccines to prevent influenza and pertussis are recommended during pregnancy. Prelicensure clinical trials typically have not included pregnant women, and when they are included, trials cannot detect rare events. Thus, postmarketing vaccine safety assessments are necessary. However, analysis of observational data requires detailed assessment of potential biases. Using data from 8 Vaccine Safety Datalink sites in the United States, we analyzed the association of monovalent H1N1 influenza vaccine (MIV) during pregnancy with preterm birth (<37 weeks) and small-for-gestational-age birth (birth weight < 10th percentile). The cohort included 46,549 pregnancies during 2009-2010 (40% of participants received the MIV). We found potential biases in the vaccine-birth outcome association that might occur due to variable access to vaccines, the time-dependent nature of exposure to vaccination within pregnancy (immortal time bias), and confounding from baseline differences between vaccinated and unvaccinated women. We found a strong protective effect of vaccination on preterm birth (relative risk = 0.79, 95% confidence interval: 0.74, 0.85) when we ignored potential biases and no effect when accounted for them (relative risk = 0.91; 95% confidence interval: 0.83, 1.0). In contrast, we found no important biases in the association of MIV with small-for-gestational-age birth. Investigators conducting studies to evaluate birth outcomes after maternal vaccination should use statistical approaches to minimize potential biases.
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MESH Headings
- Adult
- Bias
- Comorbidity
- Databases, Factual
- Female
- Humans
- Infant, Newborn
- Infant, Small for Gestational Age
- Influenza A Virus, H1N1 Subtype/drug effects
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza Vaccines/administration & dosage
- Influenza Vaccines/adverse effects
- Influenza, Human/immunology
- Influenza, Human/prevention & control
- Influenza, Human/virology
- Maternal Age
- Observational Studies as Topic/methods
- Observational Studies as Topic/standards
- Pregnancy
- Pregnancy Complications, Infectious/immunology
- Pregnancy Complications, Infectious/prevention & control
- Pregnancy Complications, Infectious/virology
- Pregnancy Outcome/epidemiology
- Pregnancy Trimesters/drug effects
- Pregnancy Trimesters/immunology
- Premature Birth/epidemiology
- Premature Birth/immunology
- Prevalence
- Product Surveillance, Postmarketing/methods
- Product Surveillance, Postmarketing/statistics & numerical data
- Propensity Score
- Retrospective Studies
- Risk Assessment
- Time Factors
- United States/epidemiology
- Young Adult
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Cox B, Vicedo-Cabrera AM, Gasparrini A, Roels HA, Martens E, Vangronsveld J, Forsberg B, Nawrot TS. Ambient temperature as a trigger of preterm delivery in a temperate climate. J Epidemiol Community Health 2016; 70:1191-1199. [DOI: 10.1136/jech-2015-206384] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 04/05/2016] [Accepted: 05/03/2016] [Indexed: 11/03/2022]
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Phadke VK, Omer SB. Maternal vaccination for the prevention of influenza: current status and hopes for the future. Expert Rev Vaccines 2016; 15:1255-80. [PMID: 27070268 DOI: 10.1080/14760584.2016.1175304] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Influenza is an important cause of morbidity and mortality among pregnant women and young infants, and influenza infection during pregnancy has also been associated with adverse obstetric and birth outcomes. There is substantial evidence - from randomized trials and observational studies - that maternal influenza immunization can protect pregnant women and their infants from influenza disease. In addition, there is compelling observational evidence that prevention of influenza in pregnant women can also protect against certain adverse pregnancy outcomes, including stillbirth and preterm birth. In this article we will review and evaluate the literature on both the burden of influenza disease in pregnant women and infants, as well as the multiple potential benefits of maternal influenza immunization for mother, fetus, and infant. We will also review key clinical aspects of maternal influenza immunization, as well as identify remaining knowledge gaps, and discuss avenues for future investigation.
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Affiliation(s)
- Varun K Phadke
- a Division of Infectious Diseases, School of Medicine , Emory University , Atlanta , GA , USA
| | - Saad B Omer
- b Department of Pediatrics, School of Medicine , Emory University , Atlanta , GA , USA.,c Departments of Global Health and Epidemiology, Rollins School of Public Health , Emory University , Atlanta , GA , USA.,d Emory Vaccine Center , Emory University , Atlanta , GA , USA
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Safety of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis and Influenza Vaccinations in Pregnancy. Obstet Gynecol 2016; 126:1069-1074. [PMID: 26444109 DOI: 10.1097/aog.0000000000001066] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To evaluate the safety of coadministering tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) and influenza vaccines during pregnancy by comparing adverse events after concomitant and sequential vaccination. METHODS We conducted a retrospective cohort study of pregnant women aged 14-49 years in the Vaccine Safety Datalink from January 1, 2007, to November 15, 2013. We compared medically attended acute events (fever, any acute reaction) and adverse birth outcomes (preterm delivery, low birth weight, small for gestational age) in women receiving concomitant Tdap and influenza vaccination and women receiving sequential vaccination. RESULTS Among 36,844 pregnancies in which Tdap and influenza vaccines were administered, the vaccines were administered concomitantly in 8,464 (23%) pregnancies and sequentially in 28,380 (77%) pregnancies. Acute adverse events after vaccination were rare. We found no statistically significant increased risk of fever or any medically attended acute adverse event in pregnant women vaccinated concomitantly compared with sequentially. When analyzing women at 20 weeks of gestation or greater during periods of influenza vaccine administration, there were no differences in preterm delivery, low-birth-weight, or small-for-gestational-age neonates between women vaccinated concomitantly compared with sequentially in pregnancy. CONCLUSION Concomitant administration of Tdap and influenza vaccines during pregnancy was not associated with a higher risk of medically attended adverse acute outcomes or birth outcomes compared with sequential vaccination. LEVEL OF EVIDENCE II.
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Hughes MM, Katz J, Mullany LC, Khatry SK, LeClerq SC, Darmstadt GL, Tielsch JM. Seasonality of birth outcomes in rural Sarlahi District, Nepal: a population-based prospective cohort. BMC Pregnancy Childbirth 2014; 14:310. [PMID: 25195204 PMCID: PMC4162951 DOI: 10.1186/1471-2393-14-310] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 09/01/2014] [Indexed: 02/06/2023] Open
Abstract
Background While seasonality of birth outcomes has been documented in a variety of settings, data from rural South Asia are lacking. We report a descriptive study of the seasonality of prematurity, low birth weight, small for gestational age, neonatal deaths, and stillbirths in the plains of Nepal. Methods Using data collected prospectively during a randomized controlled trial of neonatal skin and umbilical cord cleansing with chlorhexidine, we analyzed a cohort of 23,662 babies born between September 2002 and January 2006. Project workers collected data on birth outcomes at the infant’s household. Supplemental data from other studies conducted at the same field site are presented to provide context. 95% confidence intervals were constructed around monthly estimates to examine statistical significance of findings. Results Month of birth was associated with higher risk for adverse outcomes (neonatal mortality, low birthweight, preterm, and small for gestational age), even when controlling for maternal characteristics. Infants had 87% (95% CI: 27 – 176%) increased risk of neonatal mortality when born in August, the high point, versus March, the low point. Conclusion Seasonality of neonatal deaths, stillbirths, birth weight, gestational age, and small for gestational age were found in Nepal. Maternal factors, meteorological conditions, infectious diseases, and nutritional status may be associated with these adverse birth outcomes. Further research is needed to understand the causal mechanisms that explain the seasonality of adverse birth outcomes. Electronic supplementary material The online version of this article (doi:10.1186/1471-2393-14-310) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Joanne Katz
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, Maryland 21205, USA.
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Bashore CJ, Geer LA, He X, Puett R, Parsons PJ, Palmer CD, Steuerwald AJ, Abulafia O, Dalloul M, Sapkota A. Maternal mercury exposure, season of conception and adverse birth outcomes in an urban immigrant community in Brooklyn, New York, U.S.A. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:8414-42. [PMID: 25153469 PMCID: PMC4143869 DOI: 10.3390/ijerph110808414] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 07/23/2014] [Accepted: 08/04/2014] [Indexed: 02/01/2023]
Abstract
Adverse birth outcomes including preterm birth (PTB: <37 weeks gestation) and low birth weight (LBW: <2500 g) can result in severe infant morbidity and mortality. In the United States, there are racial and ethnic differences in the prevalence of PTB and LBW. We investigated the association between PTB and LBW with prenatal mercury (Hg) exposure and season of conception in an urban immigrant community in Brooklyn, New York. We recruited 191 pregnant women aged 18-45 in a Brooklyn Prenatal Clinic and followed them until delivery. Urine specimens were collected from the participants during the 6th to 9th month of pregnancy. Cord blood specimens and neonate anthropometric data were collected at birth. We used multivariate logistic regression models to investigate the odds of LBW or PTB with either maternal urinary mercury or neonate cord blood mercury. We used linear regression models to investigate the association between continuous anthropometric outcomes and maternal urinary mercury or neonate cord blood mercury. We also examined the association between LBW and PTB and the season that pregnancy began. Results showed higher rates of PTB and LBW in this cohort of women compared to other studies. Pregnancies beginning in winter (December, January, February) were at increased odds of LBW births compared with births from pregnancies that began in all other months (OR7.52 [95% CI 1.65, 34.29]). We observed no association between maternal exposure to Hg, and either LBW or PTB. The apparent lack of association is consistent with other studies. Further examination of seasonal association with LBW is warranted.
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Affiliation(s)
- Cynthia J Bashore
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Room 2234F, College Park, MD 20742-2611, USA.
| | - Laura A Geer
- Department of Environmental and Occupational Health Sciences, Downstate School of Public Health, State University of New York, Box 43,450 Clarkson Ave., Brooklyn, NY 11203-2533, USA.
| | - Xin He
- Department of Epidemiology and Biostatistics, University of Maryland College Park School of Public Health, 2234H SPH Building, College Park, MD 20742-2611, USA.
| | - Robin Puett
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Room 2234F, College Park, MD 20742-2611, USA.
| | - Patrick J Parsons
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, Department of Health, New York State University, Albany, NY 12201-0509, USA.
| | - Christopher D Palmer
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, Department of Health, New York State University, Albany, NY 12201-0509, USA.
| | - Amy J Steuerwald
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, Department of Health, New York State University, Albany, NY 12201-0509, USA.
| | - Ovadia Abulafia
- Department of Obstetrics and Gynecology, State University of New York Downstate Medical Center, 445 Lenox Road, Brooklyn, NY 11203, USA.
| | - Mudar Dalloul
- Department of Obstetrics and Gynecology, State University of New York Downstate Medical Center, 445 Lenox Road, Brooklyn, NY 11203, USA.
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Room 2234F, College Park, MD 20742-2611, USA.
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Maternal residential proximity to major roads in north west England and adverse pregnancy outcomes. J Occup Environ Med 2014; 55:1329-36. [PMID: 24164770 DOI: 10.1097/jom.0b013e3182a3bb41] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To investigate the effects of maternal residential proximity to major roads on adverse pregnancy outcomes. METHODS Major road networks in North West England were linked to the maternal residence of 190,909 births (2004 to 2008). Distance between the residence and the nearest major road was calculated and dichotomized at 200 m. Logistic regression analyses were performed to investigate the association between distance to the major road with small for gestational age, low birth weight, and preterm birth. Analyses were adjusted for maternal age, ethnicity, socioeconomic status, parity, birth season, smoking, and body mass index. RESULTS No significant associations were observed between preterm birth (odds ratio [OR] = 1.04; 95% confidence interval [CI] = 0.98 to 1.11), low birth weight (OR = 0.99; 95% CI = 0.93 to 1.05) and small for gestational age (OR = 1.00; 95% CI = 0.95 to 1.06) and living less than 200 m from a major road. CONCLUSIONS These results, from a study with high statistical power, suggest that living less than 200 m from a major road per se does not pose any great risk of an adverse perinatal outcome. Nevertheless, it may be limited to this geographic location. Further work is needed to quantify individual pollutant effects in pregnancy.
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Nordin JD, Kharbanda EO, Vazquez Benitez G, Lipkind H, Vellozzi C, Destefano F. Maternal influenza vaccine and risks for preterm or small for gestational age birth. J Pediatr 2014; 164:1051-1057.e2. [PMID: 24582484 DOI: 10.1016/j.jpeds.2014.01.037] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 12/03/2013] [Accepted: 01/17/2014] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To study the impact of influenza vaccine administered to pregnant women during all trimesters on the rates of preterm and small for gestational age (SGA) births, evaluating both increased and decreased risk. STUDY DESIGN This retrospective observational matched cohort study involved 7 Vaccine Safety Datalink sites across the US for the 2004-05 through 2008-09 influenza seasons. Cohort eligibility and outcomes were determined from administrative, claims, medical records, and birth data. In propensity score- and vaccine exposure time-matched analyses, ORs for preterm and SGA births were calculated. RESULTS Among 57 554 matched vaccinated and unvaccinated pregnant women, including 16 240 women in the first trimester, maternal vaccination was not associated with increased or decreased risk for preterm birth (OR for delivery at <37 weeks gestation, 0.97 [95% CI, 0.93-1.02]; for delivery at ≤32 weeks gestation, 0.98 [95% CI, 0.86-1.12]; and for delivery at ≤34 weeks gestation, 0.96 [95% CI, 0.88-1.04]) or SGA birth (OR for <5th percentile weight for gestational age, 1.02 [95% CI, 0.96-1.09], and for <10th percentile weight for gestational age, 1.00 [95% CI, 0.96-1.04]). Similarly, first trimester vaccination was not associated with increased or decreased risk for preterm or SGA birth. CONCLUSION Receipt of trivalent inactivated influenza vaccine during pregnancy was not associated with increased or decreased risk of preterm or SGA birth. These findings support the safety of vaccinating pregnant women against influenza during the first, second, and third trimesters, and suggest that a nonspecific protective effect of the influenza vaccine for these outcomes does not exist.
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Affiliation(s)
- James D Nordin
- HealthPartners Institute for Education and Research, Minneapolis, MN
| | | | | | - Heather Lipkind
- Department of Obstetrics and Gynecology, Yale University, New Haven, CT
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Luteijn JM, Dolk H, Addor MC, Arriola L, Barisic I, Bianchi F, Calzolari E, Draper E, Garne E, Gatt M, Haeusler M, Khoshnood B, McDonnell B, Nelen V, O'Mahony M, Mullaney C, Queisser-Luft A, Rankin J, Tucker D, Verellen-Dumoulin C, de Walle H, Yevtushok L. Seasonality of congenital anomalies in Europe. ACTA ACUST UNITED AC 2014; 100:260-9. [DOI: 10.1002/bdra.23231] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 01/23/2014] [Accepted: 01/28/2014] [Indexed: 12/13/2022]
Affiliation(s)
- Johannes Michiel Luteijn
- Institute of Nursing Research/School of Nursing; University of Ulster; Jordanstown Campus Newtownabbey United Kingdom
| | - Helen Dolk
- Institute of Nursing Research/School of Nursing; University of Ulster; Jordanstown Campus Newtownabbey United Kingdom
| | | | - Larraitz Arriola
- Public Health Division of Gipuzkoa; Instituto BIO-Donostia, Basque Government, CIBER Epidemiología y Salud Pública - CIBERESP; Spain
| | - Ingeborg Barisic
- Children's Hospital Zagreb; Medical School University of Zagreb; Croatia
| | - Fabrizio Bianchi
- Unit of Epidemiology; Institute of Clinical Physiology; Pisa Italy
| | - Elisa Calzolari
- IMER Registry - Azienda Ospedaliero-Universitaria di Ferrara; Ferrara Italy
| | - Elizabeth Draper
- Department of Health Sciences; University of Leicester; Leicester United Kingdom
| | - Ester Garne
- Department of Paediatrics; Hospital Lillebaelt; Kolding Denmark
| | - Miriam Gatt
- Malta Congenital Anomalies Registry; Department of Health Information; Guardamangia Malta
| | | | | | | | - Vera Nelen
- Provinciaal Instituut voor Hygiene; Antwerp Belgium
| | | | | | | | - Judith Rankin
- Institute of Health & Society; Newcastle-upon-Tyne; United Kingdom
| | | | | | | | - Lyubov Yevtushok
- OMNI-Net for Children and Rivne Medical Diagnostic Center; Rivne Ukraine
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Pomeroy E, Wells JC, Stanojevic S, Miranda JJ, Cole TJ, Stock JT. Birth month associations with height, head circumference, and limb lengths among peruvian children. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2014; 154:115-24. [DOI: 10.1002/ajpa.22484] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 01/18/2014] [Indexed: 12/20/2022]
Affiliation(s)
- Emma Pomeroy
- Newnham CollegeUniversity of CambridgeCambridge UK
- Division of Biological AnthropologyDepartment of Archaeology and AnthropologyUniversity of CambridgeCambridge UK
| | | | - Sanja Stanojevic
- Division of Respiratory MedicineThe Hospital for Sick ChildrenToronto ON Canada
| | - J. Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases and Department of MedicineSchool of Medicine, Universidad Peruana Cayetano HerediaLima Peru
| | - Tim J. Cole
- Centre of Paediatric Epidemiology and BiostatisticsUCL Institute of Child HealthLondon UK
| | - Jay T. Stock
- Division of Biological AnthropologyDepartment of Archaeology and AnthropologyUniversity of CambridgeCambridge UK
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Beltran AJ, Wu J, Laurent O. Associations of meteorology with adverse pregnancy outcomes: a systematic review of preeclampsia, preterm birth and birth weight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 11:91-172. [PMID: 24362545 PMCID: PMC3924438 DOI: 10.3390/ijerph110100091] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 11/25/2013] [Accepted: 11/27/2013] [Indexed: 11/24/2022]
Abstract
The relationships between meteorology and pregnancy outcomes are not well known. This article reviews available evidence on the relationships between seasonality or meteorology and three major pregnancy outcomes: the hypertensive disorders of pregnancy (including preeclampsia, eclampsia and gestational hypertension), gestational length and birth weight. In total 35, 28 and 27 studies were identified for each of these outcomes. The risks of preeclampsia appear higher for women with conception during the warmest months, and delivery in the coldest months of the year. Delivery in the coldest months is also associated with a higher eclampsia risk. Patterns of decreased gestational lengths have been observed for births in winter, as well as summer months. Most analytical studies also report decreases in gestational lengths associated with heat. Birth weights are lower for deliveries occurring in winter and in summer months. Only a limited number of studies have investigated the effects of barometric pressure on gestational length or the effects of temperature and sunshine exposure on birth weight, but these questions appear worth investigating further. Available results should encourage further etiological research aiming at enhancing our understanding of the relationships between meteorology and adverse pregnancy outcomes, ideally via harmonized multicentric studies.
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Affiliation(s)
| | - Jun Wu
- Program in Public Health, Anteater Instruction & Research Bldg (AIRB), 653 East Peltason Drive, University of California, Irvine, CA 92697, USA.
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Wang J, Williams G, Guo Y, Pan X, Tong S. Maternal exposure to heatwave and preterm birth in Brisbane, Australia. BJOG 2013; 120:1631-41. [DOI: 10.1111/1471-0528.12397] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2013] [Indexed: 12/27/2022]
Affiliation(s)
- J Wang
- School of Public Health and Social Work; Institute of Health and Biomedical Innovation (IHBI); Queensland University of Technology; Brisbane Australia
| | - G Williams
- School of Population Health; University of Queensland; Brisbane Australia
| | - Y Guo
- School of Population Health; University of Queensland; Brisbane Australia
| | - X Pan
- School of Public Health; Peking University; Beijing China
| | - S Tong
- School of Public Health and Social Work; Institute of Health and Biomedical Innovation (IHBI); Queensland University of Technology; Brisbane Australia
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Abstract
A large literature describes relationships between month of birth, birth weight, and gestation. These relationships are hypothesized to reflect the causal impact of seasonal environmental factors. However, recent work casts doubt on this interpretation by showing that mothers with lower socioeconomic status are more likely to give birth in months that are associated with poorer birth outcomes. Seasonality in the numbers of conceptions in different months can also induce a mechanical correlation between preterm birth and month of birth. This paper analyzes the seasonality of health at birth using a large sample of 647,050 groups of US siblings representing 1,435,213 children. By following the same mother over time, we eliminate differences in fixed maternal characteristics as an explanation for seasonal differences in health at birth. We find a sharp trough in gestation length among babies conceived in May, which corresponds to an increase in prematurity of more than 10%. Birth weight conditional on gestation length, however, is found to be strongly hump-shaped over the year, with 8-9 additional g for summer conceptions. We examine several potential mechanisms for explaining seasonality in birth outcomes that have generally been dismissed in the literature on seasonality in rich countries, notably disease prevalence and nutrition. The May trough in gestation length coincides with a higher influenza prevalence in January and February, when these babies are nearing full term, whereas the hump shape in birth weight is associated with a similar pattern in pregnancy weight gain.
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Wolf J, Armstrong B. The association of season and temperature with adverse pregnancy outcome in two German states, a time-series analysis. PLoS One 2012; 7:e40228. [PMID: 22792247 PMCID: PMC3391296 DOI: 10.1371/journal.pone.0040228] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 06/03/2012] [Indexed: 11/23/2022] Open
Abstract
Background A seasonality of low birth weight (LBW) and preterm birth (PTB) has been described for most regions and there is evidence that this pattern is caused by ambient outdoor temperature. However, the association as such, the direction of effect and the critical time of exposure remain controversial. Methods Logistic, time-series regression was performed on nearly 300,000 births from two German states to study the association between season and daily mean temperature and changes in daily proportions of term LBW (tLBW) or PTB. Analyses were adjusted for time-varying factors. Temperature exposures were examined during different periods of pregnancy. Results Weak evidence for an association between season of conception, season of birth or ambient outdoor temperature and tLBW or PTB was found. Results of analyses of temperature were not consistent between the two states. Different sources of bias which would have artificially led to stronger findings were detected and are described. Conclusions No clear evidence for an association between season of conception, season of birth or temperature and tLBW or PTB was found. In the study of pregnancy outcome different sources of bias can be identified which can potentially explain heterogeneous findings of the past.
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Affiliation(s)
- Jennyfer Wolf
- Department of Social and Environmental Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
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Blondel B, Lelong N, Kermarrec M, Goffinet F. La santé périnatale en France métropolitaine de 1995 à 2010. Résultats des enquêtes nationales périnatales. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.sagf.2012.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Blondel B, Lelong N, Kermarrec M, Goffinet F. Trends in perinatal health in France from 1995 to 2010. Results from the French National Perinatal Surveys. ACTA ACUST UNITED AC 2012; 41:e1-e15. [DOI: 10.1016/j.jgyn.2012.04.014] [Citation(s) in RCA: 218] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 04/10/2012] [Accepted: 04/16/2012] [Indexed: 11/24/2022]
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La santé périnatale en France métropolitaine de 1995 à 2010. Résultats des enquêtes nationales périnatales. ACTA ACUST UNITED AC 2012; 41:151-66. [DOI: 10.1016/j.jgyn.2011.11.008] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 11/07/2011] [Accepted: 11/21/2011] [Indexed: 11/21/2022]
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Baroutis G, Mousiolis A, Hoffman D, Antsaklis A. Preterm birth seasonality in Greece: an epidemiological study. J Matern Fetal Neonatal Med 2011; 25:1406-12. [PMID: 22070139 DOI: 10.3109/14767058.2011.636103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Seasonality of preterm birth has been noted, although not conclusively studied. Weather is also thought to play a role. We sought preterm birth seasonality and additionally studied the effect of weather parameters in the preterm birth pattern. METHODS Vital statistics from the Hellenic Statistical Authority were retrieved, covering the years from 1980 to 2008. Additionally, weather data were retrieved for the years of the study. Time series analysis was used to create various statistical models that would be compared to each other for their accuracy to predict preterm birth. Factors used in the modeling included month of birth, gender and weather factors. RESULTS Preterm birth seasonality was exhibited. Two peaks of higher risk of preterm birth were noted: One during summer and one during winter. Males were more influenced by seasonality and exhibited slightly different seasonal patterns than females, although no higher risk for preterm birth was noted. The best model that described seasonal pattern of preterm birth was the one that included meteorological factors. Notably, extreme (hotter or colder) weather was accompanied by an increase in preterm birth. CONCLUSIONS Evidence for seasonality of preterm birth was shown and extreme weather was associated with a higher incidence of it.
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Simonsen H, Shand AJ, Scott NW, Eagles JM. Seasonal symptoms in bipolar and primary care patients. J Affect Disord 2011; 132:200-8. [PMID: 21429586 DOI: 10.1016/j.jad.2011.02.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 02/17/2011] [Accepted: 02/17/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is evidence of seasonality in bipolar affective disorder (BAD) and the preponderance of atypical symptoms in bipolar depressive episodes is also seen in winter type Seasonal Affective Disorder. Differences in seasonal symptoms between BAD and appropriate comparison populations have been scrutinised only in small studies. METHODS Symptoms described on the Seasonal Pattern Assessment Questionnaire (SPAQ) were compared between 183 patients with BAD and 468 patients consulting their general practitioners. Statistical analyses were adjusted for differing age and gender distributions between the two groups. RESULTS Compared with the general practice patients, subjects with BAD reported greater seasonal fluctuations in mood (p=0.003). On one measure BAD subjects reported increased seasonal changes in social activity (p<0.001) and greater weight fluctuation over the year (p=0.001). The most striking differences were in sleep patterns; BAD subjects slept significantly more throughout the year, and slept for a mean of 1.8h more in winter than in summer (versus a 1.0h difference in the general practice group, p<0.001). Against 20% of the general practice group, 46% of BAD patients rated seasonal changes in well-being to be at least a moderate problem. LIMITATIONS The SPAQ was designed as a screening instrument for Seasonal Affective Disorder, not for studies of this nature. Some of the reported differences, notably in social activity and weight changes, may reflect secondary psychosocial effects of BAD. CONCLUSIONS Seasonal changes, most notably winter hypersomnia, should be identified in patients with BAD. These symptoms may respond to treatments such as light therapy that are used in recurrent winter depression.
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Strand LB, Barnett AG, Tong S. Methodological challenges when estimating the effects of season and seasonal exposures on birth outcomes. BMC Med Res Methodol 2011; 11:49. [PMID: 21501523 PMCID: PMC3102035 DOI: 10.1186/1471-2288-11-49] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Accepted: 04/18/2011] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Many previous studies have found seasonal patterns in birth outcomes, but with little agreement about which season poses the highest risk. Some of the heterogeneity between studies may be explained by a previously unknown bias. The bias occurs in retrospective cohorts which include all births occurring within a fixed start and end date, which means shorter pregnancies are missed at the start of the study, and longer pregnancies are missed at the end. Our objective was to show the potential size of this bias and how to avoid it. METHODS To demonstrate the bias we simulated a retrospective birth cohort with no seasonal pattern in gestation and used a range of cohort end dates. As a real example, we used a cohort of 114,063 singleton births in Brisbane between 1 July 2005 and 30 June 2009 and examined the bias when estimating changes in gestation length associated with season (using month of conception) and a seasonal exposure (temperature). We used survival analyses with temperature as a time-dependent variable. RESULTS We found strong artificial seasonal patterns in gestation length by month of conception, which depended on the end date of the study. The bias was avoided when the day and month of the start date was just before the day and month of the end date (regardless of year), so that the longer gestations at the start of the study were balanced by the shorter gestations at the end. After removing the fixed cohort bias there was a noticeable change in the effect of temperature on gestation length. The adjusted hazard ratios were flatter at the extremes of temperature but steeper between 15 and 25°C. CONCLUSIONS Studies using retrospective birth cohorts should account for the fixed cohort bias by removing selected births to get unbiased estimates of seasonal health effects.
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Affiliation(s)
- Linn Beate Strand
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Adrian G Barnett
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Shilu Tong
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
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