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Bruckner TA, Huo S, Fresson J, Zeitlin J. Preterm births among male and female conception cohorts in France during initial COVID-19 societal restrictions. Ann Epidemiol 2024; 91:58-64. [PMID: 38280410 DOI: 10.1016/j.annepidem.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/22/2023] [Accepted: 01/23/2024] [Indexed: 01/29/2024]
Abstract
PURPOSE A recent meta-analysis finds reduced risk of preterm birth (PTB; <37 weeks gestational age) during the initial stage of COVID-19 in which infection rates remained relatively low but many societies imposed restrictions on movement. None of this work, however, examines sex-specific responses despite much literature on other ambient "shocks" which would predict male sensitivity. We use a conception cohort approach to explore potential sex-specific PTB responses in France, a country which imposed a lockdown in Spring 2020. METHODS We applied interrupted time series methods using national data in France for 207 weeks among 1403,284 males and 1341,359 females conceived from 19 Jan 2016 to 6 Jan 2020. RESULTS For males in utero, the 1st COVID-19 societal lockdown corresponds with a - 0.60 per 100 conception reduction in PTB cases per week, for 12 consecutive weeks (95% confidence interval [CI]: -.36, -.84). For females in utero, the PTB reduction is smaller (-0.40 reduction per 100 conceptions, for 10 consecutive weeks, 95% CI: -.15, -.61). A formal test of sex differences in the PTB response indicates a stronger reduction in male (vs. female) PTB during the lockdown (p = .001). CONCLUSIONS Explanations for the counterintuitive reduction in PTB during COVID-19 among cohorts in utero during Spring 2020 should consider mechanisms that disproportionately affect males.
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Affiliation(s)
- Tim A Bruckner
- Center for Population, Inequality and Policy, University of California, Irvine, Irvine, CA, USA; Program in Public Health University of California, Irvine, Irvine, CA, USA.
| | - Shutong Huo
- Program in Public Health University of California, Irvine, Irvine, CA, USA
| | - Jeanne Fresson
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, France; University Hospital (CHRU), Nancy, France, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, France
| | - Jennifer Zeitlin
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, France
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Gailey S. Changes in Residential Greenspace and Birth Outcomes among Siblings: Differences by Maternal Race. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6790. [PMID: 37754649 PMCID: PMC10531468 DOI: 10.3390/ijerph20186790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/06/2023] [Accepted: 08/19/2023] [Indexed: 09/28/2023]
Abstract
Growing research investigates the perinatal health benefits of greenspace in a mother's prenatal environment. However, evidence of associations between residential greenspace and birth outcomes remains mixed, limiting the relevance this work holds for urban policy and greening interventions. Past research relies predominantly on cross-sectional designs that are vulnerable to residential selection bias, and rarely tests effect modification by maternal race/ethnicity, which may contribute to heterogeneous findings. This study uses a rigorous, longitudinal sibling comparison design and maternal fixed effect analyses to test whether increases in maternal exposure to residential greenspace between pregnancies precede improved birth outcomes among non-Hispanic (NH) white (n = 247,285) and Black (n = 54,995) mothers (mean age = 28 years) who had at least two consecutive live births in California between 2005 and 2015. Results show that increases in residential greenspace correspond with higher birthweight (coef. = 75.49, 95% CI: 23.48, 127.50) among Black, but not white (coef. = -0.51, 95% CI: -22.90, 21.90), infants. Additional analyses suggest that prior evidence of perinatal benefits associated with residential greenspace among white mothers may arise from residential selection; no such bias is observed for Black mothers. Taken together, these findings support urban greening initiatives in historically under-resourced neighborhoods. Efforts to evenly distribute residential greenspace may reduce persistent racial disparities in birth outcomes, an important step towards promoting health equity across the life course.
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Affiliation(s)
- Samantha Gailey
- Department of Forestry, Michigan State University, East Lansing, MI 48824, USA;
- Department of Public Health, Michigan State University, Flint, MI 48502, USA
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Bruckner TA, Bustos B, Margerison C, Gemmill A, Casey J, Catalano R. Selection in utero against male twins in the United States early in the COVID-19 pandemic. Am J Hum Biol 2023; 35:e23830. [PMID: 36333973 PMCID: PMC10023263 DOI: 10.1002/ajhb.23830] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/13/2022] [Accepted: 10/16/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES We aim to contribute to the literature reporting tests of selection in utero. The theory of reproductive suppression predicts that natural selection would conserve mechanisms, referred to collectively as selection in utero, that spontaneously abort fetuses unlikely to thrive as infants in the prevailing environment. Tests of this prediction include reports that women give birth to fewer than expected male twins, historically among the frailest of infants, during stressful times. The onset of the COVID-19 pandemic in the United States in Spring 2020 demonstrably stressed the population. We test the hypothesis that conception cohorts in gestation at the onset of the pandemic in the United States yielded fewer than expected live male twin births. METHODS We retrieved deidentified data on the universe of live births in the United States from the National Center for Health Statistics birth certificate records. We applied Box-Jenkins time-series methods to the twin secondary sex ratio computed for 77 monthly conception cohorts spanning August 2013 to December 2019 to detect outlying cohorts in gestation at the onset of the pandemic. RESULTS The twin secondary sex ratio fell below expected values in three conception cohorts (i.e., July, September, and October 2019, all p < .05) exposed in utero to the onset of the pandemic. CONCLUSIONS Our results add to prior findings consistent with selection in utero. The role of selection in utero in shaping the characteristics of live births cohorts, especially during the COVID-19 pandemic, warrants further scrutiny.
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Affiliation(s)
- Tim A Bruckner
- Department of Health, Society, and Behavior, and the Center for Population, Inequality, and Policy, University of California, Irvine, California, USA
| | - Brenda Bustos
- Program in Public Health, University of California, Irvine, California, USA
| | - Claire Margerison
- Deparment of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - Alison Gemmill
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joan Casey
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, USA
| | - Ralph Catalano
- School of Public Health, University of California, Berkeley, California, USA
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Parayiwa C, Harley D, Richardson A, Behie A. Severe cyclones and sex-specific birth outcomes in Queensland, Australia: An interrupted time-series analysis. Am J Hum Biol 2023; 35:e23846. [PMID: 36484299 PMCID: PMC10078530 DOI: 10.1002/ajhb.23846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES A male is less adaptable to biological stressors than a female fetus with consequent higher morbidity and mortality. Adverse birth outcomes increase and male livebirths decrease after environmental disasters, economic crises, and terrorist events. We hypothesized the ratio of male to female livebirths would decrease in areas affected by severe tropical cyclones (TCs) in Queensland, Australia. Additionally, in male livebirths, there would be an increase in preterm and low birthweight births. Lastly, we hypothesized that the pregnancy stage at which exposure occurred would modify the association between TC exposure and observed outcomes. METHODS Interrupted time series analysis was used to analyze Queensland administrative birth records from July 2007 to June 2018 for significant changes in the sex ratio at birth, measured as the proportion of male livebirths. Adjusted generalized linear models were fitted to births in areas affected by two category five TCs: cyclones Yasi (February 2011) and Marcia (February 2015). To explore male mortality and morbidity risk, additional analysis was conducted on the proportion of male stillborn, low birthweight, and preterm births. The association between estimated pregnancy stage during the TC and the proportion of male births was also analyzed. RESULTS Contrary to our hypothesis, increases in the proportion of male livebirths were observed following early-pregnancy exposure to cyclone Yasi and mid-pregnancy exposure to Marcia, although the latter was not statistically significant. No significant changes were observed in proportions of male stillborn, low birthweight, and preterm births. CONCLUSIONS This study found a significant association between severe TCs and sex ratio at birth. The stage of pregnancy at which maternal stressors were experienced modified this association. Among people exposed in early to mid-pregnancy, the proportion of male births was higher. This may be because of differential loss of females in utero. Studying sex differences in birth outcomes provides insight into in utero vulnerabilities associated with environmental stressors. Climate change is increasing the intensity and frequency of natural disasters. Understanding fetal vulnerability to environmental stressors will provide crucial information supporting early life health interventions that mitigate the immediate and long-term effects.
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Affiliation(s)
- Cynthia Parayiwa
- School of Archaeology and Anthropology, The Australian National University, Canberra, Australia
| | - David Harley
- UQ Centre for Clinical Research, Brisbane, The University of Queensland, Queensland, Australia
| | - Alice Richardson
- School of Archaeology and Anthropology, The Australian National University, Canberra, Australia
| | - Alison Behie
- School of Archaeology and Anthropology, The Australian National University, Canberra, Australia
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Bruckner TA, Huo S, Huynh M, Du S, Young A, Ro A. Psychiatric Emergencies in Los Angeles County During, and After, Initial COVID-19 Societal Restrictions: An Interrupted Time-Series Analysis. Community Ment Health J 2022; 59:622-630. [PMID: 36509936 PMCID: PMC9744376 DOI: 10.1007/s10597-022-01043-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/13/2022] [Indexed: 12/14/2022]
Abstract
Emergency department (ED) visits for psychiatric care in the US reportedly declined during the COVID-19 pandemic. This work, however, does not control for strong temporal patterning in visits before the pandemic and does not examine a potential "rebound" in demand for psychiatric care following the relaxation of initial societal restrictions. Here, we examine COVID-19-related perturbations in psychiatric care during and after the 1st stage of societal restrictions in the largest safety-net hospital in Los Angeles. We retrieved psychiatric ED visit data (98,888 total over 156 weeks, Jan 2018 to Dec 2020) from Los Angeles County + USC Medical Center. We applied interrupted time series methods to identify and control for autocorrelation in psychiatric ED visits before examining their relation with the 1st stage of societal restrictions (i.e., March 13 to May 8, 2020), as well as the subsequent "rebound" period of relaxed restrictions (i.e., after May 8, 2020). Psychiatric ED visits fell by 78.13 per week (i.e., 12%) during the 1st stage of societal restrictions (SD = 23.99, p < 0.01). Reductions in ED visits for alcohol use, substance use, and (to a lesser extent) anxiety disorders accounted for the overall decline. After the 1st stage of societal restrictions, however, we observe no "rebound" above expected values in psychiatric ED visits overall (coef = - 16.89, SD = 20.58, p = 0.41) or by diagnostic subtype. This pattern of results does not support speculation that, at the population level, foregoing ED care during initial societal restrictions subsequently induced a psychiatric "pandemic" of urgent visits.
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Affiliation(s)
- Tim A Bruckner
- Program in Public Health, University of California, Irvine, Irvine, USA.
| | - Shutong Huo
- Program in Public Health, University of California, Irvine, Irvine, USA
| | - Michael Huynh
- Program in Public Health, University of California, Irvine, Irvine, USA
| | - Senxi Du
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, USA
| | - Andrew Young
- Harbor UCLA Medical Center, University of California, Los Angeles, Los Angeles, USA
| | - Annie Ro
- Program in Public Health, University of California, Irvine, Irvine, USA
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Masukume G, Ryan M, Masukume R, Zammit D, Grech V, Mapanga W. COVID-19 onset reduced the sex ratio at birth in South Africa. PeerJ 2022; 10:e13985. [PMID: 36061753 PMCID: PMC9435519 DOI: 10.7717/peerj.13985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/10/2022] [Indexed: 01/19/2023] Open
Abstract
Background The sex ratio at birth (defined as male/(male+female) live births) is anticipated to approximate 0.510 with a slight male excess. This ratio has been observed to decrease transiently around 3-5 months following sudden unexpected stressful events. We hypothesised that stress engendered by the onset of the COVID-19 pandemic may have caused such a decrease in South Africa 3-5 months after March 2020 since in this month, South Africa reported its first COVID-19 case, death and nationwide lockdown restrictions were instituted. Methods We used publicly available, recorded monthly live birth data from Statistics South Africa. The most recent month for which data was available publicly was December 2020. We analysed live births for a 100-month period from September 2012 to December 2020, taking seasonality into account. Chi-squared tests were applied. Results Over this 100-month period, there were 8,151,364 live births. The lowest recorded monthly sex ratio at birth of 0.499 was in June 2020, 3 months after March 2020. This June was the only month during this period where the sex ratio inverted i.e., fewer male live births occurred. The predicted June 2020 ratio was 0.504. The observed June 2020 decrease was statistically significant p = 0.045. Conclusions The sex ratio at birth decreased and inverted in South Africa in June 2020, for the first time, during the most recent 100-month period. This decline occurred 3 months after the March 2020 onset of COVID-19 in South Africa. As June 2020 is within the critical window when population stressors are known to impact the sex ratio at birth, these findings suggest that the onset of the COVID-19 pandemic engendered population stress with notable effects on pregnancy and public health in South Africa. These findings have implications for future pandemic preparedness and social policy.
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Affiliation(s)
| | - Margaret Ryan
- School of Social Work and Social Policy, Trinity College Dublin, Dublin, Ireland
| | - Rumbidzai Masukume
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Victor Grech
- Academic Department of Paediatrics, Medical School, Mater Dei Hospital, Msida, Malta
| | - Witness Mapanga
- Division of Medical Oncology, Department of Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd., Johannesburg, South Africa
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Ro A, Bruckner TA, Huynh MP, Du S, Young A. Emergency Department Utilization Among Undocumented Latino Patients During the COVID-19 Pandemic. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01382-8. [PMID: 35982287 PMCID: PMC9388205 DOI: 10.1007/s40615-022-01382-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 02/06/2023]
Abstract
Objective To determine whether Latino undocumented immigrants had a steeper decline in Emergency Department (ED) utilization compared to Latino Medi-Cal patients in a Los Angeles safety-net hospital, March 13, 2020, to May 8, 2020. Study Design The data were extracted from patient medical records for ED visits at LAC + USC Medical Center from January 2018 to September 2020. We analyzed weekly ED encounters among undocumented Latino patients in the nine-week period after COVID was declared a national emergency. We applied time-series routines to identify and remove autocorrelation in ED encounters before examining its relation with the COVID-19 pandemic. We included Latino patients 18 years of age and older who were either on restricted or full-scope Medi-Cal (n = 230,195). Results All low-income Latino patients, regardless of immigration status, experienced a significant decline in ED utilization during the first nine weeks of the pandemic. Undocumented patients, however, experienced an even steeper decline. ED visits for this group fall below expected levels between March 13, 2020, and May 8, 2020 (coef. = − 38.67; 95% CI = − 71.71, − 5.63). When applied to the weekly mean of ED visits, this translates to a 10% reduction below expected levels in ED visits during this time period. Conclusion Undocumented immigrants’ health care utilization was influenced by external events that occurred early in the pandemic, such as strict stay-at-home orders and the public charge rule change. Health care institutions and local policy efforts could work to ensure that hospitals are safer spaces for undocumented immigrants to receive care without immigration concerns.
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Affiliation(s)
- Annie Ro
- Department of Health, Society, and Behavior, Anteater Instruction and Research Building (AIRB), UC Irvine Program in Public Health, 653 E. Peltason Road, Irvine, CA, 92697, USA.
| | - Tim A Bruckner
- Department of Health, Society, and Behavior, Anteater Instruction and Research Building (AIRB), UC Irvine Program in Public Health, 653 E. Peltason Road, Irvine, CA, 92697, USA
| | - Michael Pham Huynh
- Department of Health, Society, and Behavior, Anteater Instruction and Research Building (AIRB), UC Irvine Program in Public Health, 653 E. Peltason Road, Irvine, CA, 92697, USA
| | - Senxi Du
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Andrew Young
- Division of Geriatric, Hospital, Palliative and General Internal Medicine, Department of Medicine, Keck School of Medicine, Los Angeles, CA, USA
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Curtis DS, Smith KR, Chae DH, Washburn T, Lee H, Kim J, Kramer MR. Highly public anti-Black violence and preterm birth odds for Black and White mothers. SSM Popul Health 2022; 18:101112. [PMID: 35535210 PMCID: PMC9077530 DOI: 10.1016/j.ssmph.2022.101112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/22/2022] [Accepted: 04/27/2022] [Indexed: 12/02/2022] Open
Abstract
Highly public anti-Black violence may increase preterm birth in the general population of pregnant women via stress-mediated paths, particularly Black women exposed in early gestation. To examine spillover from racial violence in the US, we included a total of 49 high publicity incidents of the following types: police lethal force toward Black persons, legal decisions not to indict/convict officers involved, and hate crime murders of Black victims. National search interest in these incidents was measured via Google Trends to proxy for public awareness of racial violence. Timing of racial violence was coded in relation to a three-month preconception period and subsequent pregnancy trimesters, with the primary hypothesis being that first trimester exposure is associated with higher preterm birth odds. The national sample included 1.6 million singleton live births to US-born Black mothers and 6.6 million births to US-born White mothers from 2014 to 2017. Using a preregistered analysis plan, findings show that Black mothers had 5% higher preterm birth odds when exposed to any high publicity racial incidents relative to none in their first trimester, and 2-3% higher preterm birth odds with each log10 increase in national interest. However, post hoc sensitivity tests that included month fixed effects attenuated these associations to null. For White mothers, associations were smaller but of a similar pattern, and were attenuated when including month fixed effects. Highly public anti-Black violence may act as a national stressor, yet whether racial violence is associated with reproductive outcomes in the population is unknown and merits further research.
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Affiliation(s)
- David S. Curtis
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, 84112, USA
| | - Ken R. Smith
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, 84112, USA
| | - David H. Chae
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, 70112, USA
| | - Tessa Washburn
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, 84112, USA
| | - Hedwig Lee
- Department of Sociology, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Jaewhan Kim
- Department of Physical Therapy, University of Utah, Salt Lake City, UT, 84112, USA
| | - Michael R. Kramer
- Department of Epidemiology, Emory University, Atlanta, GA, 30322, USA
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Trinh NT, de Visme S, Cohen JF, Bruckner T, Lelong N, Adnot P, Rozé JC, Blondel B, Goffinet F, Rey G, Ancel PY, Zeitlin J, Chalumeau M. Recent historic increase of infant mortality in France: A time-series analysis, 2001 to 2019. Lancet Reg Health Eur 2022; 16:100339. [PMID: 35252944 PMCID: PMC8891691 DOI: 10.1016/j.lanepe.2022.100339] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The infant mortality rate (IMR) serves as a key indicator of population health. Methods We used data from the French National Institute of Statistics and Economic Studies on births and deaths during the first year of life from 2001 to 2019 to calculate IMR aggregated by month. We ran joinpoint regressions to identify inflection points and assess the linear trend of each segment. Exploratory analyses were performed for overall IMR, as well as by age at death subgroups (early neonatal [D0-D6], late neonatal [D7-27], and post-neonatal [D28-364]), and by sex. We performed sensitivity analyses by excluding deaths at D0 and using other time-series modeling strategies. Results Over the 19-year study period, 53,077 infant deaths occurred, for an average IMR of 3·63/1000 (4·00 in male, 3·25 in female); 24·4% of these deaths occurred during the first day of life and 47·8% during the early neonatal period. Joinpoint analysis identified two inflection points in 2005 and 2012. The IMR decreased sharply from 2001 to 2005 (slope: -0·0167 deaths/1000 live births/month; 95%CI: -0·0219 to -0·0116) and then decreased slowly between 2005 and 2012 (slope: -0·0041; 95%CI: -0·0065 to -0·0016). From 2012 onwards, a significant increase in IMR was observed (slope: 0·0033; 95%CI: 0·0011 to 0·0056). Subgroup analyses indicated that these trends were driven notably by an increase in the early neonatal period. Sensitivity analyses provided consistent results. Interpretation The recent historic increase in IMR since 2012 in France should prompt urgent in-depth investigation to understand the causes and prepare corrective actions. Funding No financial relationships with any organizations that might have an interest in the submitted work in the previous three years, no other relationships or activities that could appear to have influenced the submitted work.
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Inoue Y, Mizoue T. A preliminary analysis of the secondary sex ratio decline after the COVID-19 pandemic in Japan. Am J Hum Biol 2022; 34:e23750. [PMID: 35388546 PMCID: PMC9073960 DOI: 10.1002/ajhb.23750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/27/2022] [Accepted: 03/26/2022] [Indexed: 12/01/2022] Open
Abstract
Objectives The secondary sex ratio (SSR, i.e., the number of male births per 100 female births) has long been proposed as a sentinel health indicator. Studies have suggested that exogenous environmental stressors reduce SSR after 3 to 6 months (via disproportionate male fetus deaths) and after 9 months (via reduced male conception). We aimed to examine whether SSR declined after the coronavirus disease 2019 (COVID‐19) pandemic in Japan. Methods We used monthly vital statistics records collected between January 2013 and April 2021 (the ‐number of male and female live births, in particular). Using information reported before the pandemic struck Japan (i.e., January 2013 to January 2020), we predicted SSRs for the months after the pandemic (i.e., February 2020 to April 2021) and compared reported and predicted SSRs. We also stratified the analysis by including two groups of prefectures with different degrees of possible influence from the pandemic. Results We observed a significant reduction in SSR during December 2020 of 102.81 (i.e., 9–10 months after the pandemic affected the country), which was below the lower bound of the 95% prediction intervals (103.12–106.33). This was the lowest SSR observed during the 100‐month study period. In addition, the reduction in SSR during December 2020 was more pronounced in the more seriously affected prefectures. Conclusion In Japan, we found a significant reduction in SSR (i.e., fewer male live births) 9–10 months after COVID‐19 was declared a pandemic. This suggests the onset of the COVID‐19 pandemic was a significant population‐level stressor.
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Affiliation(s)
- Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Gailey S, Knudsen ES, Mortensen LH, Bruckner TA. Birth outcomes following unexpected job loss: a matched-sibling design. Int J Epidemiol 2021; 51:858-869. [PMID: 34508593 DOI: 10.1093/ije/dyab180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 08/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Research documents social and economic antecedents of adverse birth outcomes, which may include involuntary job loss. Previous work on job loss and adverse birth outcomes, however, lacks high-quality individual data on, and variation in, plausibly exogenous job loss during pregnancy and therefore cannot rule out strong confounding. METHODS We analysed unique linked registries in Denmark, from 1980 to 2017, to examine whether a father's involuntary job loss during his spouse's pregnancy increases the risk of a low-weight (i.e. <2500 grams) and/or preterm (i.e. <37 weeks of gestational age) birth. We applied a matched-sibling design to 743 574 sibling pairs. RESULTS Results indicate an increased risk of a low-weight birth among infants exposed in utero to fathers' unexpected job loss [odds ratio (OR) = 1.37, 95% confidence interval (CI): 1.07, 1.75]. Sex-specific analyses show that this result holds for males (OR = 1.70, 95% CI: 1.14, 2.53) but not females (OR = 1.24, 95% CI: 0.80, 1.91). We find no relation with preterm birth. CONCLUSIONS Findings support the inference that a father's unexpected job loss adversely affects the course of pregnancy, especially among males exposed in utero.
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Affiliation(s)
- Samantha Gailey
- Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA
| | - Elias Stapput Knudsen
- Department of Technology, Management, and Economics, Technical University of Denmark, Copenhagen, Denmark
| | - Laust H Mortensen
- Denmark Statistics, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tim A Bruckner
- Program in Public Health, University of California Irvine, Irvine, CA, USA.,Center for Population, Inequality, and Policy, University of California Irvine, Irvine, CA, USA
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12
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Bruckner TA, Catalano R, Das A, Lu Y. Cohort Selection In Utero against Male Twins and Childhood Cancers: A Population-Based Register Study. Cancer Epidemiol Biomarkers Prev 2021; 30:1834-1840. [PMID: 34272267 PMCID: PMC8974355 DOI: 10.1158/1055-9965.epi-21-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/28/2021] [Accepted: 06/15/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Cancer ranks as the second leading cause of death among children ages 1 to 14 years in the United States. Previous research finds that strong cohort selection in utero against males precedes a reduction in live-born males considered frail. We examine whether such cohort selection in utero may similarly affect the frequency of childhood cancers among male live births. METHODS We examined 1,368 childhood cancers among males born in Sweden over 144 months, from January 1990 to December 2001, and followed to age 15 in the Swedish Cancer Registry. We retrieved the count of male twins by birth month from the Swedish Birth Registry. We applied autoregressive, integrated, moving average time-series methods to identify and control for temporal patterns in monthly childhood cancers and to evaluate robustness of results. RESULTS Fewer childhood cancers occur among monthly male birth cohorts with elevated selection in utero (i.e., a low count of live-born male twins). This association appears in the concurrent month (coef = 0.04; 95% CI, 0.001-0.079) as well as in the following month in which most births from the twin's conception cohort are "scheduled" to be born (coef = 0.055; 95% CI, 0.017-0.094). CONCLUSIONS Elevated cohort selection in utero may reduce the number of frail male gestations that would otherwise have survived to birth and received a cancer diagnosis during childhood. IMPACT This novel result warrants further investigation of prenatal exposures, including those at the population level, that may induce cohort selection in utero for some cancer types but not others.
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Affiliation(s)
- Tim A. Bruckner
- Program in Public Health, University of California, Irvine, Irvine, California.,Center for Population, Inequality, and Policy, University of California, Irvine, Irvine, California.,Corresponding Author: Tim A. Bruckner, Program in Public Health, University of California, Irvine, Irvine, CA 92617. E-mail:
| | - Ralph Catalano
- School of Public Health, University of California, Berkeley, Berkeley, California
| | - Abhery Das
- Program in Public Health, University of California, Irvine, Irvine, California
| | - Yunxia Lu
- Program in Public Health, University of California, Irvine, Irvine, California
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Ehrlich SF. Maternal Diabetes and Infant Sex Ratio. Curr Diab Rep 2021; 21:24. [PMID: 34110514 PMCID: PMC8284925 DOI: 10.1007/s11892-021-01395-3] [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] [Accepted: 05/28/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW Evolutionary hypotheses on the ratio of males to females at birth posit that women terminate pregnancies with low likelihood of surviving and producing grandchildren. Thus, females are preferred to males under unfavorable conditions. Much of this literature has focused on catastrophic disruptions that induce maternal stress and result in fewer males. Diabetes may similarly affect the sex ratio. RECENT FINDINGS A male bias at birth among infants born to women with GDM is widely recognized; mild hyperglycemia experienced early in pregnancy may signal favorable conditions and warrant investment in males. There are sparse data on women with pregestational diabetes, but some evidence for a female bias born to those with type 1 diabetes and severe hyperglycemia (i.e., requiring insulin). Disease-related maternal stress in these women may lead to the selective termination of male fetuses. Further examination of pregestational diabetes stands to contribute to scientific understanding of the sex ratio.
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Affiliation(s)
- Samantha F Ehrlich
- The University of Tennessee, Knoxville, 390 HPER, 1914 Andy Holt Ave, Knoxville, TN, 37996, USA.
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14
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Is divisive politics making Americans sick? Associations of perceived partisan polarization with physical and mental health outcomes among adults in the United States. Soc Sci Med 2021; 284:113976. [PMID: 34247898 DOI: 10.1016/j.socscimed.2021.113976] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/04/2021] [Accepted: 04/23/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To investigate whether changes in perceived partisan polarization since the 2016 US presidential election and current perceptions of polarization are associated with the onset of physical and mental health conditions in adults. METHODS We surveyed a nationally-representative sample (n = 2752) of US adults between December 2019 and January 2020. We used multivariable logistic regression to estimate associations between perceived polarization and the incidence of hypertension, high cholesterol, obesity, diabetes, and anxiety, depressive, and sleep disorders in or after 2016 and current self-rated health. Our secondary exposure variables measured perceptions of mass and elite polarization at the state and national level. Perceived mass polarization measured perceptions of the partisan gap between Democrat and Republican voters; perceived elite polarization measured perceptions of the partisan gap between Democrat and Republican elected officials. RESULTS Participants reporting an increase in polarization had 52-57% higher odds of developing depressive disorders (OR = 1.52, 95% CI: 1.01, 2.29, P = 0.047) and anxiety disorders (OR = 1.57, 95% CI: 1.07, 2.29, P = 0.02) compared to participants who perceived no change in polarization. Those reporting high (vs. low) levels of perceived state-level mass polarization had a 49% higher odds of incident depressive disorders (P = 0.03). Participants who perceived high levels of state-level elite polarization reported a 71% higher odds of incident depressive disorders (P = 0.004) and a 49% higher odds of incident sleep disorders (P = 0.03). CONCLUSIONS Perceptions of partisan polarization may represent important factors that are linked to the onset of mental health and sleep disorders.
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Brown R. The Intergenerational Impact of Terror: Did the 9/11 Tragedy Impact the Initial Human Capital of the Next Generation? Demography 2020; 57:1459-1481. [PMID: 32514847 DOI: 10.1007/s13524-020-00876-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Given the unexpected nature of the terrorist attacks of September 11, 2001, a specific cohort of children were exogenously exposed to increased maternal psychological stress in utero. Rich administrative data and the precise timing of the event allow this study to uniquely provide insights into the health effects of exposure to maternal psychological stress across gestation. Results suggest that children exposed in utero were born significantly smaller and earlier than previous cohorts. The timing of the effect provides evidence that intrauterine growth is specifically restricted by first trimester exposure to stress; reductions in gestational age and increases in the likelihood of being born at low (<2,500 grams) or very low (<1,500 grams) birth weight are induced by increased maternal psychological stress mid-pregnancy. This study also documents a positively selected post-attack fertility response, which would bias an evaluation that includes cohorts conceived after September 11, 2001, in the control group.
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Affiliation(s)
- Ryan Brown
- University of Colorado Denver, 1380 Lawrence Street, Denver, CO, 80204, USA.
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Calleja T. The assassinations of investigative journalists Daphne Caruana Galizia and Veronica Guerin and the male-to-female birth ratio. Early Hum Dev 2020; 141:104950. [PMID: 31923751 DOI: 10.1016/j.earlhumdev.2019.104950] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/26/2019] [Accepted: 12/31/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Male live births are marginally more common than female ones. At a population level, this ratio (M/F) temporarily reduces in the months after major traumatic events. This study looks at whether the M/F live birth ratios in Malta and Ireland were affected by the assassinations of local investigative journalists Daphne Caruana Galizia (DCG) and Veronica Guerin (VG) respectively. METHODS Data on monthly live births by gender in Malta and Ireland were gathered from the Maltese Public Health Directorate for Health Information and Research and the Irish Central Statistics Office online database respectively. M/F ratios at 3 to 5 months after the assassinations were compared to the monthly M/F ratio in the months preceding and following the events. In the case of DCG, the study period was from January 2017 to December 2018, while in the case of VG, it was taken to be from November 1995 to October 1997. RESULTS In Malta, during the study period, there were 8914 live births (M/F 0.5139; 95% CI 0.514-0.524). There was a significant dip (χ2 = 5.1, p = 0.02) of the M/F ratio 4 months after DCG's assassination to 0.4529. This translates to an estimated loss of 21 male live births. In Ireland, during the study period, there were 102,368 live births (M/F = 0.5162; 95% CI 0.513-0.519). There was a significant dip (χ2 = 4.5, p = 0.03) of the M/F ratio 4 months after VG's assassination to 0.5. This translates to an estimated loss of 72 male live births. DISCUSSION These findings add weight to the argument that national stressful events may be related to dips in the M/F ratio. Assassinations of journalists may have important population mental health implications.
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Affiliation(s)
- Thomas Calleja
- Department of Adolescent and Child Health, Mater Dei Hospital, Malta.
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