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Okui T, Nakashima N. Exploring the association between non-regular employment and adverse birth outcomes: an analysis of national data in Japan. Ann Occup Environ Med 2024; 36:e6. [PMID: 38623263 PMCID: PMC11016784 DOI: 10.35371/aoem.2024.36.e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/01/2024] [Accepted: 02/26/2024] [Indexed: 04/17/2024] Open
Abstract
Background As few studies have explored the association between non-regular or precarious employment in parents and adverse birth outcomes, this study aimed to investigate this association using national data in Japan. Methods This study utilized the census data from 2020 and birth data from the vital statistics in 2021 and 2022 in the analysis. Adverse birth outcomes, including preterm birth, term low birth weight (TLBW), and small-for-gestational-age, were examined. Data linkage was conducted between birth data and census data to link parental employment statuses and educational attainments with birth data. Rates of adverse birth outcomes were calculated for each parental employment status. Additionally, regression analysis was used to determine adjusted risk ratios (RRs) of parental employment statuses for each birth outcome. Results After data linkage, 334,110 birth records were included in the statistical analysis. Rates for non-regular workers were consistently higher than those for regular workers across all adverse birth outcomes for maternal employment status. Results of regression analyses indicated that the risks of preterm birth for non-regular workers were statistically significantly higher than those for regular workers, both in mothers and fathers with a RR (95% confidence intervals [CIs]) of 1.053 (1.004-1.104) and 1.142 (1.032-1.264), respectively. Furthermore, the risk of TLBW birth for non-regular workers was statistically significantly higher than that for regular workers in fathers (RR [95% CI]: 1.092 [1.043-1.143]). Conclusions Our findings demonstrate that non-regular workers have a higher risk of some adverse birth outcomes compared to regular workers.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Naoki Nakashima
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
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Huang Y, Alvernaz S, Kim SJ, Maki P, Dai Y, Bernabé BP. Predicting prenatal depression and assessing model bias using machine learning models. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.17.23292587. [PMID: 37503225 PMCID: PMC10371186 DOI: 10.1101/2023.07.17.23292587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Perinatal depression (PND) is one of the most common medical complications during pregnancy and postpartum period, affecting 10-20% of pregnant individuals. Black and Latina women have higher rates of PND, yet they are less likely to be diagnosed and receive treatment. Machine learning (ML) models based on Electronic Medical Records (EMRs) have been effective in predicting postpartum depression in middle-class White women but have rarely included sufficient proportions of racial and ethnic minorities, which contributed to biases in ML models for minority women. Our goal is to determine whether ML models could serve to predict depression in early pregnancy in racial/ethnic minority women by leveraging EMR data. We extracted EMRs from a hospital in a large urban city that mostly served low-income Black and Hispanic women (N=5,875) in the U.S. Depressive symptom severity was assessed from a self-reported questionnaire, PHQ-9. We investigated multiple ML classifiers, used Shapley Additive Explanations (SHAP) for model interpretation, and determined model prediction bias with two metrics, Disparate Impact, and Equal Opportunity Difference. While ML model (Elastic Net) performance was low (ROCAUC=0.67), we identified well-known factors associated with PND, such as unplanned pregnancy and being single, as well as underexplored factors, such as self-report pain levels, lower levels of prenatal vitamin supplement intake, asthma, carrying a male fetus, and lower platelet levels blood. Our findings showed that despite being based on a sample mostly composed of 75% low-income minority women (54% Black and 27% Latina), the model performance was lower for these communities. In conclusion, ML models based on EMRs could moderately predict depression in early pregnancy, but their performance is biased against low-income minority women.
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Affiliation(s)
- Yongchao Huang
- Department of Biomedical Engineering, Colleges of Engineering and Medicine, University of Illinois, Chicago, IL, USA
| | - Suzanne Alvernaz
- Department of Biomedical Engineering, Colleges of Engineering and Medicine, University of Illinois, Chicago, IL, USA
| | - Sage J Kim
- Division of Health Policy and Administration, School of Public Health, University of Illinois, Chicago, IL, USA
| | - Pauline Maki
- Department of Psychiatry, College of Medicine, University of Illinois, Chicago, IL, USA
- Department of Psychology, College of Medicine, University of Illinois, Chicago, IL, USA
- Department of Obstetrics and Gynecology, College of Medicine, University of Illinois, Chicago, IL, USA
| | - Yang Dai
- Department of Biomedical Engineering, Colleges of Engineering and Medicine, University of Illinois, Chicago, IL, USA
- Center of Bioinformatics and Quantitative Biology, University of Illinois, Chicago, IL, USA
| | - Beatriz Penñalver Bernabé
- Department of Biomedical Engineering, Colleges of Engineering and Medicine, University of Illinois, Chicago, IL, USA
- Center of Bioinformatics and Quantitative Biology, University of Illinois, Chicago, IL, USA
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Garbazza C, Hackethal S, Migliore E, D'Agostino A, Serrati C, Fanti V, Riccardi S, Baiardi S, Cicolin A, Borgwardt S, Mondini S, Cirignotta F, Cajochen C, Manconi M. Influence of chronotype on the incidence and severity of perinatal depression in the "Life-ON" study. J Affect Disord 2022; 317:245-255. [PMID: 36055526 DOI: 10.1016/j.jad.2022.08.064] [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: 10/04/2021] [Revised: 05/10/2022] [Accepted: 08/21/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Perinatal depression (PND) is a severe complication of pregnancy, but there are no established risk factors predicting the disease. Evening chronotype has been associated with unhealthy lifestyle habits and adverse outcomes during pregnancy. In this study, we aimed to clarify whether chronotype can predict symptoms and/or occurrence of PND. METHODS Two hundred ninety-nine women were followed-up from the first trimester of pregnancy until 6 months postpartum. Chronotype was assessed at baseline using the MEQ, while mood was repeatedly assessed by depression rating scales (EPDS, HDRS, MADRS). The influence of time and chronotype on EPDS, HDRS and MADRS, was estimated by constructing multilevel linear mixed regression models. A Cox proportional-hazard regression model was built to evaluate the association between chronotype and incidence of depression. RESULTS Chronotype modulated PND symptom severity depending on time of assessment, with evening chronotypes having a higher risk for developing PND symptoms, as assessed by EPDS, at postpartum visits V4 (5-12 days) and V5 (19-26 days). These also had less healthy lifestyle habits and were more likely to suffer from gestational diabetes mellitus and undergo cesarean delivery as compared to other chronotypes. LIMITATIONS Only a minority of women were classified as evening chronotypes. The long follow-up phase of the study led to missing data. CONCLUSIONS Pregnant evening chronotypes show unhealthy lifestyle habits and sociodemographic characteristics commonly associated with a higher risk for PND. They also have a higher risk of developing PND symptoms in the first month after delivery. Chronotype should therefore be routinely assessed during pregnancy to identify women potentially at risk for developing PND.
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Affiliation(s)
- Corrado Garbazza
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland; Centre for Chronobiology, University of Basel, Basel, Switzerland; Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.
| | - Sandra Hackethal
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland
| | - Enrica Migliore
- Clinical Epidemiology Unit, University Hospital Città Della Salute e Della Scienza di Torino, Turin, Italy; Cancer Epidemiology Unit, University Hospital Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Armando D'Agostino
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Chiara Serrati
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Valentina Fanti
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Silvia Riccardi
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland
| | - Simone Baiardi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; Department of Experimental, Diagnostics, and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Alessandro Cicolin
- Sleep Medicine Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland; Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Susanna Mondini
- Neurology Unit, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
| | | | - Christian Cajochen
- Centre for Chronobiology, University of Basel, Basel, Switzerland; Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Mauro Manconi
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
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Abenova M, Myssayev A, Kanya L, Turliuc MN, Jamedinova U. Prevalence of postpartum depression and its associated factors within a year after birth in Semey, Kazakhstan: A cross sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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