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Gerede A, Stavros S, Chatzakis C, Vavoulidis E, Papasozomenou P, Domali E, Nikolettos K, Oikonomou E, Potiris A, Tsikouras P, Nikolettos N. Cannabis Use during Pregnancy: An Update. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1691. [PMID: 39459478 PMCID: PMC11509407 DOI: 10.3390/medicina60101691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Revised: 10/01/2024] [Accepted: 10/11/2024] [Indexed: 10/28/2024]
Abstract
The use of cannabis during pregnancy has emerged as a mounting cause for concern due to its potential adverse consequences on both the mother and her offspring. This review will focus on the dangers associated with prenatal exposure to cannabis, particularly those related to neurodevelopment. It will also discuss the features of maternal and placental functioning that are likely to have long-term effects on the offspring's development. The most pertinent and up-to-date materials can be found through a literature search. The literature emphasizes the substantial hazards associated with prenatal exposure to cannabis. These include impairments in cognitive function and difficulties in behavior in this particular instance. Structural and functional alterations in the brain can be noticed in offspring. The use of cannabis has been associated with an increased likelihood of experiencing pregnancy-related complications, such as giving birth prematurely and having a baby with a low birth weight. Additionally, it has been connected to potential negative effects on mental and emotional well-being. Studies have shown that when a pregnant woman is exposed to cannabis, it can negatively impact the functioning of the placenta and the growth of the fetus. This might potentially contribute to the development of placental insufficiency and restricted growth in the womb. Longitudinal studies reveal that children who were exposed to cannabis in the womb experience additional long-term developmental challenges, such as decreased cognitive abilities, reduced academic performance, and behavioral issues. In order to address the problem of cannabis usage during pregnancy, it is essential to adopt a comprehensive and coordinated strategy. This method should integrate and synchronize public health policy, education, and research initiatives. By implementing these targeted strategies, it is possible to mitigate potential health and welfare concerns for both present and future generations.
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Affiliation(s)
- Angeliki Gerede
- Unit of Maternal-Fetal-Medicine, Department of Obstetrics and Gynecology, Medical School, Democritus University of Thrake, 8100 Alexandroupolis, Greece; (K.N.); (E.O.); (P.T.); (N.N.)
| | - Sofoklis Stavros
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.S.); (A.P.)
| | - Christos Chatzakis
- Second Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, 54640 Thessaloniki, Greece; (C.C.); (E.V.)
| | - Eleftherios Vavoulidis
- Second Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, 54640 Thessaloniki, Greece; (C.C.); (E.V.)
| | - Panagiota Papasozomenou
- Midwifery Department, Health Sciences School, International Hellenic University, 57400 Thessalonik, Greece;
| | - Ekaterini Domali
- First Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Konstantinos Nikolettos
- Unit of Maternal-Fetal-Medicine, Department of Obstetrics and Gynecology, Medical School, Democritus University of Thrake, 8100 Alexandroupolis, Greece; (K.N.); (E.O.); (P.T.); (N.N.)
| | - Efthymios Oikonomou
- Unit of Maternal-Fetal-Medicine, Department of Obstetrics and Gynecology, Medical School, Democritus University of Thrake, 8100 Alexandroupolis, Greece; (K.N.); (E.O.); (P.T.); (N.N.)
| | - Anastasios Potiris
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.S.); (A.P.)
| | - Panagiotis Tsikouras
- Unit of Maternal-Fetal-Medicine, Department of Obstetrics and Gynecology, Medical School, Democritus University of Thrake, 8100 Alexandroupolis, Greece; (K.N.); (E.O.); (P.T.); (N.N.)
| | - Nikolaos Nikolettos
- Unit of Maternal-Fetal-Medicine, Department of Obstetrics and Gynecology, Medical School, Democritus University of Thrake, 8100 Alexandroupolis, Greece; (K.N.); (E.O.); (P.T.); (N.N.)
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Li X, Mei F, Xiao WC, Zhang F, Zhang S, Fu P, Chen J, Shan R, Sun BK, Song SB, Yuan C, Liu Z. Differentiated thyroid cancer and adverse pregnancy outcomes: a propensity score-matched retrospective cohort study. Front Pediatr 2024; 12:1377061. [PMID: 39328585 PMCID: PMC11424406 DOI: 10.3389/fped.2024.1377061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 08/30/2024] [Indexed: 09/28/2024] Open
Abstract
Background Differentiated thyroid cancer (DTC) has been increasingly common in women of reproductive age. However, the evidence remains mixed regarding the association of DTC with adverse pregnancy outcomes in pregnant women previously diagnosed with DTC. Methods We conducted a retrospective cohort study in the Peking University Third Hospital in Beijing, China between January 2012 and December 2022. We included singleton-pregnancy women with a pre-pregnancy DTC managed by surgical treatment (after-surgery DTC) or active surveillance (under-surveillance DTC). To reduce the confounding effects, we adopted a propensity score to match the after-surgery and under-surveillance DTC groups with the non-DTC group, respectively, on age, parity, gravidity, pre-pregnancy weight, height, and Hashimoto's thyroiditis. We used conditional logistics regressions, separately for the after-surgery and under-surveillance DTC groups, to estimate the adjusted associations of DTC with both the composite of adverse pregnancy outcomes and the specific mother-, neonate-, and placenta-related pregnancy outcomes. Results After the propensity-score matching, the DTC and non-DTC groups were comparable in the measured confounders. In the after-surgery DTC group (n = 204), the risk of the composite or specific adverse pregnancy outcomes was not significantly different from that of the matched, non-DTC groups (n = 816; P > 0.05), and the results showed no evidence of difference across different maternal thyroid dysfunctions, gestational thyrotropin levels, and other pre-specified subgroup variables. We observed broadly similar results in the under-surveillance DTC group (n = 37), except that the risk of preterm birth, preeclampsia, and delivering the low-birth-weight births was higher than that of the matched, non-DTC group [n = 148; OR (95% CI): 4.79 (1.31, 17.59); 4.00 (1.16, 13.82); 6.67 (1.59, 27.90)]. Conclusions DTC was not associated with adverse pregnancy outcomes in pregnant women previously treated for DTC. However, more evidence is urgently needed for pregnant women with under-surveillance DTC, which finding will be clinically significant in individualizing prenatal care.
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Affiliation(s)
- Xin Li
- Department of General Surgery, Peking University Third Hospital, Beijing, China
| | - Fang Mei
- School of Basic Medical Sciences, Health Science Centre, Peking University, Beijing, China
| | - Wu-Cai Xiao
- Department of Maternal and Child Health, School of Public Health, Health Science Centre, Peking University, Beijing, China
| | - Fan Zhang
- Department of Ultrasound, Peking University Third Hospital, Beijing, China
| | - Shanghang Zhang
- National Key Laboratory for Multimedia Information Processing, School of Electronics Engineering and Computer Science, Faculty of Information and Engineering Science, Peking University, Beijing, China
| | - Peng Fu
- Department of Ultrasound, Peking University Third Hospital, Beijing, China
| | - Jing Chen
- Department of Maternal and Child Health, School of Public Health, Health Science Centre, Peking University, Beijing, China
| | - Rui Shan
- Department of Maternal and Child Health, School of Public Health, Health Science Centre, Peking University, Beijing, China
| | - Bang-Kai Sun
- Information Management and Big Data Center, Peking University Third Hospital, Beijing, China
| | - Shi-Bing Song
- Department of General Surgery, Peking University Third Hospital, Beijing, China
| | - Chunhui Yuan
- Department of General Surgery, Peking University Third Hospital, Beijing, China
| | - Zheng Liu
- Department of Maternal and Child Health, School of Public Health, Health Science Centre, Peking University, Beijing, China
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Jones H, Seaborne MJ, Kennedy NL, James M, Dredge S, Bandyopadhyay A, Battaglia A, Davies S, Brophy S. Cohort profile: Born in Wales-a birth cohort with maternity, parental and child data linkage for life course research in Wales, UK. BMJ Open 2024; 14:e076711. [PMID: 38238056 PMCID: PMC10806724 DOI: 10.1136/bmjopen-2023-076711] [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: 06/14/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
PURPOSE Using Wales's national dataset for maternity and births as a core dataset, we have linked related datasets to create a more complete and comprehensive entire country birth cohort. Data of anonymised identified persons are linked on the individual level to data from health, social care and education data within the Secure Anonymised Information Linkage (SAIL) Databank. Each individual is assigned an encrypted Anonymised Linking Field; this field is used to link anonymised individuals across datasets. We present the descriptive data available in the core dataset, and the future expansion plans for the database beyond its initial development stage. PARTICIPANTS Descriptive information from 2011 to 2023 has been gathered from the National Community Child Health Database (NCCHD) in SAIL. This comprehensive dataset comprises over 400 000 child electronic records. Additionally, survey responses about health and well-being from a cross-section of the population including 2500 parents and 30 000 primary school children have been collected for enriched personal responses and linkage to the data spine. FINDINGS TO DATE The electronic cohort comprises all children born in Wales since 2011, with follow-up conducted until they finish primary school at age 11. The child cohort is 51%: 49% female: male, and 7.8% are from ethnic minority backgrounds. When considering age distribution, 26.8% of children are under the age of 5, while 63.2% fall within the age range of 5-11. FUTURE PLANS Born in Wales will expand by 30 000 new births annually in Wales (in NCCHD), while including follow-up data of children and parents already in the database. Supplementary datasets complement the existing linkage, including primary care, hospital data, educational attainment and social care. Future research includes exploring the long-term implications of COVID-19 on child health and development, and examining the impact of parental work environment on child health and development.
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Affiliation(s)
- Hope Jones
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, UK
| | - Mike J Seaborne
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, UK
| | - Natasha L Kennedy
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, UK
- Swansea University Medical School, Administrative Data Research Wales, Swansea, UK
| | - Michaela James
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, UK
| | - Sam Dredge
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, UK
| | - Amrita Bandyopadhyay
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, UK
| | | | - Sarah Davies
- Betsi Cadwaladr University Health Board, Bangor, UK
- Health and Care Research Wales, Cardiff, UK
| | - Sinead Brophy
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, UK
- Swansea University Medical School, Administrative Data Research Wales, Swansea, UK
- Health Data Research UK, London, UK
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Kennedy N, Win TL, Bandyopadhyay A, Kennedy J, Rowe B, McNerney C, Evans J, Hughes K, Bellis MA, Jones A, Harrington K, Moore S, Brophy S. Insights from linking police domestic abuse data and health data in South Wales, UK: a linked routine data analysis using decision tree classification. Lancet Public Health 2023; 8:e629-e638. [PMID: 37516479 DOI: 10.1016/s2468-2667(23)00126-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Exposure to domestic abuse can lead to long-term negative impacts on the victim's physical and psychological wellbeing. The 1998 Crime and Disorder Act requires agencies to collaborate on crime reduction strategies, including data sharing. Although data sharing is feasible for individuals, rarely are whole-agency data linked. This study aimed to examine the knowledge obtained by integrating information from police and health-care datasets through data linkage and analyse associated risk factor clusters. METHODS This retrospective cohort study analyses data from residents of South Wales who were victims of domestic abuse resulting in a Public Protection Notification (PPN) submission between Aug 12, 2015 and March 31, 2020. The study links these data with the victims' health records, collated within the Secure Anonymised Information Linkage databank, to examine factors associated with the outcome of an Emergency Department attendance, emergency hospital admission, or death within 12 months of the PPN submission. To assess the time to outcome for domestic abuse victims after the index PPN submission, we used Kaplan-Meier survival analysis. We used multivariable Cox regression models to identify which factors contributed the highest risk of experiencing an outcome after the index PPN submission. Finally, we created decision trees to describe specific groups of individuals who are at risk of experiencing a domestic abuse incident and subsequent outcome. FINDINGS After excluding individuals with multiple PPN records, duplicates, and records with a poor matching score or missing fields, the resulting clean dataset consisted of 8709 domestic abuse victims, of whom 6257 (71·8%) were female. Within a year of a domestic abuse incident, 3650 (41·9%) individuals had an outcome. Factors associated with experiencing an outcome within 12 months of the PPN included younger victim age (hazard ratio 1·183 [95% CI 1·053-1·329], p=0·0048), further PPN submissions after the initial referral (1·383 [1·295-1·476]; p<0·0001), injury at the scene (1·484 [1·368-1·609]; p<0·0001), assessed high risk (1·600 [1·444-1·773]; p<0·0001), referral to other agencies (1·518 [1·358-1·697]; p<0·0001), history of violence (1·229 [1·134-1·333]; p<0·0001), attempted strangulation (1·311 [1·148-1·497]; p<0·0001), and pregnancy (1·372 [1·142-1·648]; p=0·0007). Health-care data before the index PPN established that previous Emergency Department and hospital admissions, smoking, smoking cessation advice, obstetric codes, and prescription of antidepressants and antibiotics were associated with having a future outcome following a domestic abuse incident. INTERPRETATION The results indicate that vulnerable individuals are detectable in multiple datasets before and after involvement of the police. Operationalising these findings could reduce police callouts and future Emergency Department or hospital admissions, and improve outcomes for those who are vulnerable. Strategies include querying previous Emergency Department and hospital admissions, giving a high-risk assessment for a pregnant victim, and facilitating data linkage to identify vulnerable individuals. FUNDING National Institute for Health Research.
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Affiliation(s)
- Natasha Kennedy
- National Centre for Population Health and Wellbeing Research, Swansea, UK.
| | | | | | - Jonathan Kennedy
- National Centre for Population Health and Wellbeing Research, Swansea, UK; Administrative Data Research Wales, Swansea, UK; Data Lab, National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, UK
| | - Benjamin Rowe
- South Wales Police, South Wales Police Head Quarters Cowbridge Road, Bridgend, UK
| | - Cynthia McNerney
- Administrative Data Research Wales, Swansea, UK; SAIL Databank, Swansea, UK
| | | | | | - Mark A Bellis
- WHO Collaborating Centre for Violence Prevention, Liverpool John Moores University, Liverpool, UK
| | | | - Karen Harrington
- National Centre for Population Health and Wellbeing Research, Swansea, UK
| | - Simon Moore
- Security, Crime & Intelligence Innovation Institute and Violence Research Group, School of Dentistry, Cardiff University, Heath Park, Cardiff, UK
| | - Sinead Brophy
- National Centre for Population Health and Wellbeing Research, Swansea, UK; Health Data Research UK, Swansea, UK; Administrative Data Research Wales, Swansea, UK
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