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Bruckner TA, Trinh NTH, Lelong N, Madani K, Slama R, Given J, Khoshnood B. Climate Change and Congenital Anomalies: A Population-Based Study of the Effect of Prolonged Extreme Heat Exposure on the Risk of Neural Tube Defects in France. Birth Defects Res 2024; 116:e2397. [PMID: 39215441 DOI: 10.1002/bdr2.2397] [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: 04/14/2024] [Revised: 07/11/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Exposure to long-lasting extreme ambient temperatures in the periconceptional or early pregnancy period might increase the risk of neural tube defects (NTDs). We tested whether prolonged severe heat exposure as experienced during the 2003 extreme heatwave in France, affected the risk of NTDs. METHODS We retrieved NTD cases spanning from January 1994 to December 2018 from the Paris Registry of Congenital Malformations. The 2003 heatwave was characterized by the long duration and high intensity of nine consecutive days with temperatures ≥35°C. We classified monthly conceptions occurring in August 2003 as "exposed" to prolonged extreme heat around conception (i.e., periconceptional period). We assessed whether the risk of NTDs among cohorts exposed to the prolonged severe heatwave of 2003 in the periconceptional period differed from expected values using Poisson/negative binomial regression. FINDINGS We identified 1272 NTD cases from January 1994 to December 2018, yielding a monthly mean count of 4.24. Ten NTD cases occurred among births conceived in August 2003. The risk of NTD was increased in the cohort with periconceptional exposure to the August 2003 heatwave (relative risk = 2.14, 95% confidence interval: 1.46 to 3.13), compared to non-exposed cohorts. Sensitivity analyses excluding July and September months or restricting to summer months yielded consistent findings. INTERPRETATION Evidence from the "natural experiment" of an extreme climate event suggests an elevated risk of NTDs following exposure to prolonged extreme heat during the periconceptional period.
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Affiliation(s)
- Tim A Bruckner
- Program in Public Health, University of California, Irvine, California, USA
| | - Nhung T H Trinh
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Paris, France
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Norway
| | - Nathalie Lelong
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Paris, France
| | - Kaveh Madani
- United Nations University Institute for Water, Environment and Health (UNU-INWEH), Richmond Hill, Ontario, Canada
| | - Rémy Slama
- University Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Joanne Given
- Institute of Nursing and Health Research, Ulster University, Belfast, UK
| | - Babak Khoshnood
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Paris, France
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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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Risk factors of early mortality after neonatal surgery in Tunisia. J Pediatr Surg 2020; 55:2233-2237. [PMID: 32654833 DOI: 10.1016/j.jpedsurg.2020.05.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 05/19/2020] [Accepted: 05/29/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Research concerning factors of death after neonatal surgery is scarce. Insight into mortality might improve perioperative care. This study aimed to identify predictive factors of mortality after neonatal surgery in a low income country (LIC). METHODS Charts of all newborn patients who underwent surgical procedures under general anesthesia during the neonatal period in our department of pediatric surgery between January 2010 and December 2017 were reviewed. We used univariate and multivariate analysis to evaluate perioperative variables potentially predictive of early postoperative mortality. RESULTS One hundred eighty-two cases were included in the study: 41 newborns (28.6%) were premature (<37 weeks of gestation) and 52 (22.5%) weighed less than 2.5 kg. The most commonly diagnosed conditions were esophageal atresia (24%) and bowel obstruction (19%). Forty-four patients (24%) died during hospitalization. The highest rate of mortality was observed for congenital diaphragmatic hernia. Univariate analysis showed that perinatal predictive variables of mortality were prematurity, low birth weight, the necessity of preoperative intubation, and duration of surgery more than 2 h. Logistic regression showed three independent risk factors, which are the duration of surgery, low birth weight and the necessity of preoperative intubation. CONCLUSION The overall mortality in infants undergoing neonatal surgery is still high in LICs. Knowledge of independent risk factors of early mortality may help clinicians to more adequately manage the high-risk population. TYPE OF THE STUDY Clinical research paper. LEVEL OF EVIDENCE III.
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Tong G, Guo G. The life-course association of birth-weight genes with self-rated health. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2020; 65:268-286. [PMID: 32727274 PMCID: PMC8607814 DOI: 10.1080/19485565.2020.1765733] [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] [Indexed: 06/11/2023]
Abstract
This study examines the impact of genes associated with normal-range birth weight (2500-4500 grams) on self-rated health in mid-to-late life course. Fifty-eight previously identified genetic variants that explain the variation in the normal-range birth weight were used to construct a genetic measure of birth weight for the non-Hispanic white sample from the Health and Retirement Study. Our results show that the genetic tendency toward higher birth weight predicts better self-rated health in mid-to-late life course net of various demographic, socioeconomic, and health behavioral factors. We also examine the heterogeneous effects of birth-weight genes across birth cohorts and age groups. Moreover, to clarify the paradox that higher birth weight can predict both better self-rated health and higher BMI, we show the positive association between birth weight genes and BMI can only hold within the normal-range BMI (18 ≤ BMI < 30). Overall, these findings suggest the genetic factors underlying the normal-range birth weight can have life-courseimpacts on health.
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Affiliation(s)
- Guangyu Tong
- Yale Center for Analytical Sciences and Department of Biostatistics, Yale University , New Haven, Connecticut, USA
| | - Guang Guo
- Department of Sociology, University of North Carolina at Chapel Hill , Chapel Hill, United States
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Catalano R, Casey JA, Bruckner TA. A test of oscillation in the human secondary sex ratio. EVOLUTION MEDICINE AND PUBLIC HEALTH 2020; 2020:225-233. [PMID: 33376596 PMCID: PMC7750984 DOI: 10.1093/emph/eoaa012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 01/03/2023]
Abstract
Background and objectives The sex ratio of human birth cohorts predicts the health and longevity of their members. Most literature invokes natural selection in support of the argument that heritable tendencies to produce male or female offspring induce oscillation in the sex ratio and its sequelae. Tests of the argument remain exceedingly rare because they require vital statistics describing many generations of a population both unaffected by migration and exposed to an exogenous stressor virulent enough to change the sex ratio at birth. We contribute to the literature by using time-series modeling to detect oscillation in the best data currently available for such a test. Methodology We apply rigorous time-series methods to data describing Sweden from 1751 through 1830, a period when the population not only aged in place without migration, but also exhibited the effects of an Icelandic volcanic eruption including a historically low secondary sex ratio. That very low sex ratio should have induced oscillation if heritable mechanisms appear in humans. Results We detected oscillation in the ratio but not that predicted by heritable tendencies to produce males or females. We found peak-to-trough oscillation at 14 rather than the approximately 32 years expected from the heritable tendencies argument. Conclusions and implications Our findings suggest that mechanisms other than perturbation of heritable tendencies to produce males or females induce oscillation in the human secondary sex ratio. These other mechanisms may include reproductive suppression and selection in utero. LAY SUMMARY The male to female ratio in human birth cohorts predicts longevity but its variation over time remains unexplained. We test the long-held theory that the ratio oscillates due to heritable tendencies to produce males or females. We find oscillation, but it appears due to social processes rather than heritable mechanisms.
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Affiliation(s)
- Ralph Catalano
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Joan A Casey
- Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Tim A Bruckner
- Program in Public Health, University of California, Irvine, Irvine, CA, USA
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Margulis AV, Hernandez-Diaz S, McElrath T, Rothman KJ, Plana E, Almqvist C, D’Onofrio BM, Oberg AS. Relation of in-utero exposure to antiepileptic drugs to pregnancy duration and size at birth. PLoS One 2019; 14:e0214180. [PMID: 31381574 PMCID: PMC6681941 DOI: 10.1371/journal.pone.0214180] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 07/10/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The associations of individual antiepileptic drugs (AEDs) with pregnancy duration and size at birth, and potential dose relations, are not well characterized. METHODS This cohort study used nationwide Swedish register data (1996-2013). Adjusting for smoking, epilepsy and other AED indications, we used linear and quantile regression to explore associations with pregnancy duration, and birth weight, length, and head circumference (the last three operationalized as z-scores). We used logistic regression for preterm delivery, small for gestational age, and microcephaly. Lamotrigine was the reference drug. RESULTS 6,720 infants were exposed to AEDs in utero; AED exposure increased over the study period. Relative to lamotrigine-exposed infants, carbamazepine-exposed infants were born, on average, 1.3 days earlier (mean [95% confidence interval]: -1.3 [-2.3 to -0.3]); were 0.1 standard deviations (SDs) lighter (-0.1 [-0.2 to 0.0]); and had a head circumference that was 0.2 SDs smaller (-0.2 [-0.3 to -0.1]). Pregabalin-exposed infants were born, on average, 1.1 days earlier (-1.1 [-3.0 to 0.8]); were 0.1 SDs lighter (-0.1 [-0.3 to 0.0]); and had the same head circumference as lamotrigine-exposed infants. Levetiracetam-exposed infants were born, on average, 0.5 days earlier (-0.5 [-2.6 to 1.6]); were 0.1 SDs lighter (-0.1 [-0.3 to 0.0]); and had a head circumference 0.1 SDs smaller (-0.1 [-0.3 to 0.1]). Valproic acid-exposed infants had, on average, the same duration of gestation and birth weight z-score as lamotrigine-exposed infants, but had a head circumference 0.2 SDs smaller (-0.2 [-0.2 to -0.1]). Associations between carbamazepine exposure and pregnancy duration and between valproic acid exposure and pregnancy duration and birth weight z-score were more negative at the left than at the right tails of the outcome distributions. Effect-measure modification and dose-response relations were noted for some of the associations. CONCLUSIONS Relative to lamotrigine, valproic acid and carbamazepine were associated with smaller head circumference.
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Affiliation(s)
| | - Sonia Hernandez-Diaz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Thomas McElrath
- Division of Maternal-Fetal Medicine, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | | | | | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Brian M. D’Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, United States of America
| | - Anna Sara Oberg
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Bruckner TA, Singh P, Lelong N, Khoshnood B. Down syndrome among primiparae at older maternal age: A test of the relaxed filter hypothesis. Birth Defects Res 2019; 111:1611-1617. [PMID: 31321913 DOI: 10.1002/bdr2.1553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/30/2019] [Accepted: 07/02/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Down syndrome (DS) ranks as one of the most common birth defects in the United States. The relaxed filter hypothesis (RFH) asserts that mothers with no previous children but nearing reproductive senescence reduce fetal selectivity against DS pregnancies in the first trimester given the high probability of having no offspring at all if the DS pregnancy is not carried to term. We test the parity prediction of RFH-specifically, that pregnancies to older mothers with no previous live births show an elevated prevalence of DS above values expected from the separate contributions of older maternal age and primiparity. METHODS We retrieved maternal age and parity information on 2,748 DS cases (live, stillborn, or terminated due to anomaly) from the Paris Birth Defects Registry, 1983-2015. We used two waves of the Enquête Fertility Survey (n = 5,460) and counts of stillbirths to calculate total prevalence of DS by maternal age and parity. RESULTS Primiparous mothers 35+ years show the greatest prevalence of any parity group (9.78 cases per 1,000 deliveries). Tests for additive interaction of primiparity and older maternal age reject the null (relative excess risk due to interaction = 1.01; 95% confidence interval: 0.33, 1.69; null value on additive scale is 0). CONCLUSIONS Relaxed selection may account for 10% of the increase in the prevalence, among older primiparous mothers, of DS detected during or after the 11th week. Future work may hold implications for understanding, among older mothers, the strength of this maternal screen against other defects.
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Affiliation(s)
- Tim A Bruckner
- Program in Public Health, University of California Irvine (UCI), Irvine, California
| | - Parvati Singh
- Program in Public Health, University of California Irvine (UCI), Irvine, California
| | - Nathalie Lelong
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology, Research Team (EPOPé), Center for Epidemiology and Statistics, Sorbonne, Paris Cité (CRESS), DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Babak Khoshnood
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology, Research Team (EPOPé), Center for Epidemiology and Statistics, Sorbonne, Paris Cité (CRESS), DHU Risks in Pregnancy, Paris Descartes University, Paris, France
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Bruckner TA, Catalano R. Selection in utero and population health: Theory and typology of research. SSM Popul Health 2018; 5:101-113. [PMID: 29928686 PMCID: PMC6008283 DOI: 10.1016/j.ssmph.2018.05.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/30/2018] [Accepted: 05/31/2018] [Indexed: 01/05/2023] Open
Abstract
Public health researchers may assume, based on the fetal origins literature, that "scarring" of birth cohorts describes the population response to modern-day stressors. We contend, based on extensive literature concerned with selection in utero, that this assumption remains questionable. At least a third and likely many more of human conceptions fail to yield a live birth. Those that survive to birth, moreover, do not represent their conception cohort. Increasing data availability has led to an improved understanding of selection in utero and its implications for population health. The literature describing selection in utero, however, receives relatively little attention from social scientists. We aim to draw attention to the rich theoretical and empirical literature on selection in utero by offering a typology that organizes this diverse work along dimensions we think important, if not familiar, to those studying population health. We further use the typology to identify important gaps in the literature. This work should interest social scientists for two reasons. First, phenomena of broad scholarly interest (i.e., social connectivity, bereavement) affect the extent and timing of selection in utero. Second, the life-course health of a cohort depends in part on the strength of such selection. We conclude by identifying new research directions and with a reconciliation of the apparent contradiction between the "fetal origins" literature and that describing selection in utero.
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Affiliation(s)
- Tim A. Bruckner
- Program in Public Health, University of California, Irvine, 653 E. Peltason Dr. Suite 2046, 2nd Floor, Irvine, CA 92697-3957, USA
| | - Ralph Catalano
- School of Public Health, University of California, Berkeley, 15 University Hall, Berkeley, CA 94720, USA
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Singh P, Yang W, Shaw GM, Catalano R, Bruckner TA. Selected birth defects among males following the United States terrorist attacks of 11 September 2001. Birth Defects Res 2017; 109:1277-1283. [DOI: 10.1002/bdr2.1072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 05/18/2017] [Accepted: 05/29/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Parvati Singh
- University of California Irvine, Program in Public Health; Irvine California
| | - Wei Yang
- Stanford University, School of Medicine; Stanford California
| | - Gary M. Shaw
- Stanford University, School of Medicine; Stanford California
| | - Ralph Catalano
- University of California Berkeley, School of Public Health; Berkeley California
| | - Tim A. Bruckner
- University of California Irvine, Program in Public Health; Irvine California
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