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Perret C, Alvarelhão JJM, Pennington L, Ehlinger V, Duffaut C, Arnaud C, Vidart d'Egurbide Bagazgoïtia N. Assessing the Adequacy of the Physical, Social, and Attitudinal Environment to the Specific Needs of Young Adults With Cerebral Palsy: The European Adult Environment Questionnaire. Arch Phys Med Rehabil 2024; 105:906-920. [PMID: 38206241 DOI: 10.1016/j.apmr.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 11/17/2023] [Accepted: 11/26/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES To present the development of the European Adult Environment Questionnaire (EAEQ), to assess to what extent it covers the International Classification of Functioning, Disability and Health (ICF), and to describe the adequacy of the physical, social, and attitudinal environment to the specific needs of young adults with cerebral palsy (CP). DESIGN Cross-sectional. SETTING Administrative regions in France, Germany, Italy, Portugal, and Sweden. PARTICIPANTS Young adults with CP (N=357), with varying severity profiles, aged 19-28 years at time of interview (2018-20). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE(S) Physical, social, and attitudinal environment unmet needs. RESULTS Relevant environmental factors (EFs) for young adults with CP were identified during focus groups in England and Portugal. EFs were mapped to the ICF environmental classification and the EAEQ analytical structure resulted from this linking procedure. It comprised 61 items, linked to 31 ICF environmental classification categories, and covered 4 of its 5 chapters. Content validity assessed with the bandwidth index (percentage coverage of ICF Core Sets for adults with CP) was satisfactory (79.3%). A descriptive analysis was carried out. Participants had a mean age of 24 years, 56% were men, 38% had severely limited mobility. Less than 16% reported unmet needs for EFs relating to home, college/work/day placement, and communication in the Products and technology chapter. Unmet needs were higher (>20%) for the other items in the Public use and Land development categories. Social support, attitudes, and understanding of relatives were often adequate to the participants' needs. The proportion of unmet needs varied by sex (women were more often concerned) and raised with increasing gross motor impairment. CONCLUSION The EAEQ describes in detail the adequacy of the environment to the specific needs of young adults with CP. Its ICF-based structure opens up possibilities for use in a universal conceptual framework.
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Affiliation(s)
- Célia Perret
- UMR 1295 CERPOP, Inserm, Université Toulouse III - Paul Sabatier, Team SPHERE, Toulouse, France
| | | | - Lindsay Pennington
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Virginie Ehlinger
- UMR 1295 CERPOP, Inserm, Université Toulouse III - Paul Sabatier, Team SPHERE, Toulouse, France
| | - Carine Duffaut
- UMR 1295 CERPOP, Inserm, Université Toulouse III - Paul Sabatier, Team SPHERE, Toulouse, France
| | - Catherine Arnaud
- UMR 1295 CERPOP, Inserm, Université Toulouse III - Paul Sabatier, Team SPHERE, Toulouse, France; Clinical Epidemiology Unit, University Hospital, Toulouse, France
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Patabendige M, Chan F, Vayssiere C, Ehlinger V, Van Gemund N, le Cessie S, Prager M, Marions L, Rozenberg P, Chevret S, Young DC, Le Roux PA, Gregson S, Waterstone M, Rolnik DL, Mol BW, Li W. Vaginal misoprostol versus vaginal dinoprostone for cervical ripening and induction of labour: An individual participant data meta-analysis of randomised controlled trials. BJOG 2024. [PMID: 38425020 DOI: 10.1111/1471-0528.17794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Induction of labour (IOL) is common practice and different methods carry different effectiveness and safety profiles. OBJECTIVES To compare the effectiveness, and maternal and perinatal safety outcomes of IOL with vaginal misoprostol versus vaginal dinoprostone using individual participant data from randomised clinical trials. SEARCH STRATEGY The following databases were searched from inception to March 2023: CINAHL Plus, ClinicalTrials.gov, Cochrane Pregnancy and Childbirth Group Trial Register, Ovid Embase, Ovid Emcare, Ovid MEDLINE, Scopus and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). SELECTION CRITERIA Randomised controlled trials (RCTs), with viable singleton gestation, no language restrictions, and all published and unpublished data. DATA COLLECTION AND ANALYSIS An individual participant data meta-analysis was carried out. MAIN RESULTS Ten of 52 eligible trials provided individual participant data, of which two were excluded after checking data integrity. The remaining eight trials compared low-dose vaginal misoprostol versus dinoprostone, including 4180 women undergoing IOL, which represents 32.8% of all participants in the published RCTs. Of these, 2077 were assigned to low-dose vaginal misoprostol and 2103 were assigned to vaginal dinoprostone. Compared with vaginal dinoprostone, low-dose vaginal misoprostol had a comparable rate of vaginal birth. Composite adverse perinatal outcomes did not differ between the groups. Compared with vaginal dinoprostone, composite adverse maternal outcomes were significantly lower with low-dose vaginal misoprostol (aOR 0.80, 95% CI 0.65-0.98, P = 0.03, I2 = 0%). CONCLUSIONS Low-dose vaginal misoprostol and vaginal dinoprostone for IOL are comparable in terms of effectiveness and perinatal safety. However, low-dose vaginal misoprostol is likely to lead to a lower rate of composite adverse maternal outcomes than vaginal dinoprostone.
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Affiliation(s)
- Malitha Patabendige
- Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash University, Clayton, Victoria, Australia
- Ministry of Health, Colombo, Sri Lanka
- Monash Health - Casey Hospital, Berwick, Victoria, Australia
| | - Fei Chan
- Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash University, Clayton, Victoria, Australia
| | - Christophe Vayssiere
- Centre for Epidemiology and Research in Population Health (CERPOP), UMR1295, Toulouse University, Inserm, Paul Sabatier University, Toulouse, France
- Department of Obstetrics and Gynaecology, Paule de Viguier Hospital, Toulouse University Hospital, Toulouse, France
| | - Virginie Ehlinger
- Centre for Epidemiology and Research in Population Health (CERPOP), UMR1295, Toulouse University, Inserm, Paul Sabatier University, Toulouse, France
| | - Nicolette Van Gemund
- Department of Obstetrics and Gynaecology, Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Saskia le Cessie
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands
| | - Martina Prager
- Division of Obstetrics and Gynaecology, Department of Women's and Children's Health, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Lena Marions
- Division of Obstetrics and Gynaecology, Department of Women's and Children's Health, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Patrick Rozenberg
- Department of Gynaecology and Obstetrics, Poissy Hospital, University Paris V, Paris, France
| | - Sylvie Chevret
- Department of Biostatistics, Hopital Saint-Louis, University Paris VII, INSERM, Paris, France
| | - David C Young
- Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, Nova Scotia, Canada
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Paul A Le Roux
- Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa
| | - Sarah Gregson
- Maternity Unit, Queen Mary's Sidcup NHS Trust, Kent, UK
| | | | - Daniel L Rolnik
- Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash University, Clayton, Victoria, Australia
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash University, Clayton, Victoria, Australia
| | - Wentao Li
- Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash University, Clayton, Victoria, Australia
- National Perinatal Epidemiology and Statistics Unit (NPESU), Centre for Big Data Research in Health, and School of Clinical Medicine, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Pudig L, Delobel-Ayoub M, Horridge K, Gergeli AT, Sellier E, Ehlinger V, Hollody K, Virella D, Vik T, Arnaud C. Classification of events contributing to postneonatal cerebral palsy: Development, reliability, and recommendations for use. Dev Med Child Neurol 2024; 66:250-257. [PMID: 37488719 DOI: 10.1111/dmcn.15710] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 05/25/2023] [Accepted: 06/12/2023] [Indexed: 07/26/2023]
Abstract
AIM This paper introduces the Surveillance of Cerebral Palsy in Europe (SCPE) classification of events contributing to postneonatally acquired cerebral palsy, presents its interrater reliability, and describes the cases identified in the SCPE database. METHOD The development of the classification, based on literature review and expert discussions, resulted in six main categories and 19 subcategories. The first chronological event designated as the primary event was mainly reported. Interrater reliability was assessed through online exercise providing 24 clinical vignettes representing single/complex pathways. Percent agreement and Gwet's AC1 index of reliability were estimated. Primary events were described using data of 221 children born between 2008 and 2012. RESULTS Thirty-nine professionals (21 registries) participated in the reliability exercise. Substantial overall agreement was reached (0.75), with some contrast between complex (0.48, moderate agreement) and single events involved (0.89, almost perfect). The distribution of primary events showed that 32.1% were infections (category A), 23.1% head injuries (B), 15.4% related to surgery or medical interventions (C), 13.1% cerebrovascular accidents (D), 9.1% hypoxic brain damaging events of other origins (E), and 7.2% miscellaneous (F). INTERPRETATION This classification allows all the events involved to be recorded while consistently reporting the primary event, and may be used in different settings. WHAT THIS PAPER ADDS A standardized classification enables the description of the events contributing to postneonatal cerebral palsy (CP). The first chronological event in complex pathway leading to CP is coded. Category choice and coding of the primary event identify preventable situations. The detailed 2-level classification is easy to use in various settings. Substantial overall interrater reliability shows that main categories can be consistently differentiated.
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Affiliation(s)
- Luise Pudig
- Childhood Disability Registry in Haute-Garonne, University Hospital, Toulouse, France
- Hospital for Children and Adolescents, Leipzig University, Leipzig, Germany
| | - Malika Delobel-Ayoub
- Childhood Disability Registry in Haute-Garonne, University Hospital, Toulouse, France
- CERPOP, UMR1295 Toulouse University, Inserm, Paul Sabatier University, Toulouse, France
| | - Karen Horridge
- Department of Education, University of Sunderland, Sunderland, UK
| | - Anja Troha Gergeli
- University Children's Hospital Ljubljana, Department of Child, Adolescent & Developmental Neurology, Ljubljana, Slovenia
| | - Elodie Sellier
- Grenoble Alpes University, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC-IMAG, Grenoble, France
- Registre des Handicaps de l'Enfant et Observatoire Périnatal, Grenoble, France
| | - Virginie Ehlinger
- CERPOP, UMR1295 Toulouse University, Inserm, Paul Sabatier University, Toulouse, France
| | - Katalin Hollody
- Department of Paediatrics, University of Pécs, Medical School, Pécs, Hungary
| | - Daniel Virella
- Neonatology Intensive Care Unit/Research Center, Lisbon, Central Lisbon Hospital, Portugal
| | - Torstein Vik
- The Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Catherine Arnaud
- Childhood Disability Registry in Haute-Garonne, University Hospital, Toulouse, France
- CERPOP, UMR1295 Toulouse University, Inserm, Paul Sabatier University, Toulouse, France
- Clinical Epidemiology Unit, University Hospital of Toulouse, Toulouse, France
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Estrade M, Diguisto C, Arnaud C, Ehlinger V, Vayssière PC. Comparison of cesarean delivery rates after 3 methods of cervical ripening among obese women at or after 41 weeks - Secondary analysis of two French randomized controlled trials: MAGPOP and CYTOPRO. Eur J Obstet Gynecol Reprod Biol 2023; 291:16-21. [PMID: 37806026 DOI: 10.1016/j.ejogrb.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE To compare cesarean rates and maternal and neonatal morbidity according to the cervical ripening method used among obese pregnant women requiring induction of labor at or after 41 weeks of gestation. DESIGN A secondary analysis of two multicenter randomized controlled trials conducted in French maternity units between 2015 and 2018. PARTICIPANTS 336 women with a body mass index ≥30 kg/m2, a pregnancy ≥41 weeks, and an induction of labor requiring cervical ripening. INTERVENTIONS Cervical ripening with a PGE2 dinoprostone pessary (Propess®), or low-dose vaginal PGE1 (misoprostol) or a double-balloon catheter. MEASUREMENTS AND FINDINGS The rates of cesarean delivery did not differ significantly according to the cervical ripening method (PGE2 pessary vs PGE1, RR: 1.18, 95% CI: 0.80-1.75; PGE2 pessary vs double balloon catheter: RR, 0.88, 95% CI: 0.60-1.29), p = 0.52; double balloon catheter vs PGE1, RR: 1.34, 95% CI: 0.77-2.32, p = 0.29). More oxytocin was required for women from the double-balloon group compared to those from both the PGE1 and PGE2 pessary groups (respectively, RR: 1.31, 95% CI: 1.08-1.58, p = 0.005; RR: 1.17, 95% CI: 1.03-1.32, p = 0.01). The risk of perineal tears or episiotomy was significantly lower for women induced with the PGE2 pessary than with PGE1 (0.85; 95% CI: 0.74-0.99), p = 0.03). KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE No cervical ripening method was associated with a lower cesarean rate in obese women who required cervical ripening from 41 weeks. Further trials are required among obese women to determine the cervical ripening method most efficacious for reducing the cesarean rate.
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Affiliation(s)
- Marine Estrade
- CERPOP, UMR 1295, Team SPHERE (Study of Perinatal, Pediatric and Adolescent Health: Epidemiological Research and Evaluation) Toulouse III University, Toulouse, France.
| | - Caroline Diguisto
- Pôle de gynécologie obstétrique, médecine fœtale, médecine et biologie de la reproduction, centre Olympe de Gouges, CHRU de Tours, Université de Tours, France; Université Paris Cité, Centre for Epidemiology and Statistics (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, France
| | - Catherine Arnaud
- CERPOP, UMR 1295, Team SPHERE (Study of Perinatal, Pediatric and Adolescent Health: Epidemiological Research and Evaluation) Toulouse III University, Toulouse, France
| | - Virginie Ehlinger
- CERPOP, UMR 1295, Team SPHERE (Study of Perinatal, Pediatric and Adolescent Health: Epidemiological Research and Evaluation) Toulouse III University, Toulouse, France
| | - Pr Christophe Vayssière
- CERPOP, UMR 1295, Team SPHERE (Study of Perinatal, Pediatric and Adolescent Health: Epidemiological Research and Evaluation) Toulouse III University, Toulouse, France; Department of Obstetrics and Gynecology, Paule de Viguier Hospital, Toulouse III University, Toulouse, France
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Wallach E, Ehlinger V, Biotteau M, Walther-Louvier U, Péréon Y, Vuillerot C, Fontaine S, Sabouraud P, Espil-Taris C, Cuisset JM, Laugel V, Baudou E, Arnaud C, Cances C. Confirmatory validation of the french version of the Duchenne Muscular Dystrophy module of the pediatric quality of life inventory (PedsQL TM3.0DMDfv). BMC Pediatr 2023; 23:563. [PMID: 37968589 PMCID: PMC10647061 DOI: 10.1186/s12887-023-04153-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 06/24/2023] [Indexed: 11/17/2023] Open
Abstract
Duchenne Muscular Dystrophy (DMD) is a neuromuscular disease that inevitably leads to total loss of autonomy. The new therapeutic strategies aim to both improve survival and optimise quality of life. Evaluating quality of life is nevertheless a major challenge. No DMD-specific quality of life scale to exists in French. We therefore produced a French translation of the English Duchenne Muscular Dystrophy module of the Pediatric Quality of Life Inventory (PedsQLTMDMD) following international recommendations. The study objective was to carry out a confirmatory validation of the French version of the PedsQLTMDMD for paediatric patients with DMD, using French multicentre descriptive cross-sectional data. The sample consisted of 107 patients. Internal consistency was acceptable for proxy-assessments, with Cronbach's alpha coefficients above 0.70, except for the Treatment dimension. For self-assessments, internal consistency was acceptable only for the Daily Activities dimension. Our results showed poor metric qualities for the French version of the PedsQLTMDMD based on a sample of about 100 children, but these results remained consistent with those of the original validation. This confirms the interest of its use in clinical practice.
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Affiliation(s)
- Elisabeth Wallach
- Neuropediatric Department, Toulouse-Purpan University Hospital, Toulouse, France.
| | - Virginie Ehlinger
- UMR 1295 CERPOP, Toulouse University, Inserm, University Toulouse III Paul Sabatier, Toulouse, France
| | - Maelle Biotteau
- Neuropediatric Department, Toulouse-Purpan University Hospital, Toulouse, France.
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France.
| | - Ulrike Walther-Louvier
- CHU Montpellier, Service de Neuropédiatrie, Centre de Référence Maladies Neuromusculaires AOC, Montpellier, France
| | - Yann Péréon
- Reference Centre for Neuromuscular Diseases AOC, Filnemus, Euro-NMD, Hôtel-Dieu, CHU Nantes, Nantes, France
| | - Carole Vuillerot
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, L'Escale, Service de Médecine Physique et de Réadaptation Pédiatrique, Bron, France
- NeuroMyogen Institute, CNRS UMR 5310 - INSERM U1217, University of Lyon, Lyon, France
| | - Stephanie Fontaine
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, L'Escale, Service de Médecine Physique et de Réadaptation Pédiatrique, Bron, France
| | - Pascal Sabouraud
- Department of Paediatrics, French Reference Center for Neuromuscular Diseases, American Memorial Hospital, Reims University Hospital Center, Reims, France
| | - Caroline Espil-Taris
- CHU Pellegrin, Service de neuropédiatrie, Centre de Référence Maladies Neuromusculaires AOC, Bordeaux, France
| | - Jean-Marie Cuisset
- Reference Centre for Neuromuscular Diseases Nord/Est/Ile-de-France, CHU Lille, Lille, France
- Department of Pediatric Neurology, CHU Lille, Lille, France
| | - Vincent Laugel
- Unité de neuropédiatrie et CIC pédiatrique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Eloïse Baudou
- Neuropediatric Department, Toulouse-Purpan University Hospital, Toulouse, France
| | - Catherine Arnaud
- UMR 1295 CERPOP, Toulouse University, Inserm, University Toulouse III Paul Sabatier, Toulouse, France
- Clinical Epidemiology Unit, University Hospital, Toulouse, France
| | - Claude Cances
- Neuropediatric Department, Toulouse-Purpan University Hospital, Toulouse, France
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Alberge C, Ehlinger V, Noack N, Bolzoni C, Colombié B, Breinig S, Dicky O, Delobel M, Arnaud C. Early psychomotor therapy in very preterm infants does not improve Bayley-III scales at 2 years. Acta Paediatr 2023; 112:1916-1925. [PMID: 37191836 DOI: 10.1111/apa.16848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/17/2023]
Abstract
AIM To assess the efficacy of post-hospital psychomotor therapy in the development of very preterm infants at nine and 24 months. METHODS We conducted a randomised controlled study at Toulouse Children's Hospital between 2008 and 2014 among preterm infants aged under 30 weeks. All infants in both groups could benefitt from physiotherapy to prevent motor disorders. The intervention group received 20 early post-hospital psychomotor therapy sessions. The development was assessed by the Bayley Scale Infant Development at nine and 24 months. RESULTS The intervention and control group contained 77 and 84 infants, respectively, with 57 infants in each group undergoing assessment at 24 months. Boys accounted for 56% of the population. Median gestational age was 28 weeks, range 25-29. The development scores at 24 months did not significantly differ between the randomisation groups. At 9 months, we observed improvements in global motricity (mean difference 0.9 point, p = 0.04) and fine motricity for the subgroup containing educationally underserved mothers (mean difference 1.6 point, p = 0.008). There was no significant difference in neuromotor functioning between the two groups. CONCLUSION The benefits of psychomotor therapy were short-lived and did not persist post-intervention. Our results and this organisational model encouraged us to persevere towards similar multi-professional care.
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Affiliation(s)
- Corine Alberge
- Paediatric Intensive Care Unit, Toulouse University Children's Hospital, Toulouse, France
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
| | | | - Nathalie Noack
- Regional Vulnerable Newborns Follow-up Network, Occitanie, France
| | | | - Bruno Colombié
- Regional Vulnerable Newborns Follow-up Network, Occitanie, France
| | - Sophie Breinig
- Paediatric Intensive Care Unit, Toulouse University Children's Hospital, Toulouse, France
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
| | - Odile Dicky
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
- Neonatology Department, Toulouse University Children's Hospital, Toulouse, France
| | - Malika Delobel
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
| | - Catherine Arnaud
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
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Breinig S, Ehlinger V, Rozé JC, Storme L, Torchin H, Durrmeyer X, Cambonie G, Delacourt C, Jarreau PH, Berthomieu L, Brissaud O, Benhammou V, Gascoin G, Arnaud C, Ancel PY. Pulmonary hypertension among preterm infants born at 22 through 32 weeks gestation in France: Prevalence, survival, morbidity and management in the EPIPAGE-2 cohort study. Early Hum Dev 2023; 184:105837. [PMID: 37595540 DOI: 10.1016/j.earlhumdev.2023.105837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/16/2023] [Accepted: 07/30/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE To determine the prevalence, short-term prognosis and pharmacologic management of pulmonary hypertension (PH) among very preterm infants born before 32 weeks gestation (WG). STUDY DESIGN In the EPIPAGE-2 French national prospective population-based cohort of preterm infants born in 2011, those presenting with PH were identified and prevalence was estimated using multiple imputation. The primary outcome was survival without severe morbidity at discharge and was compared between infants with or without PH after adjusting for confounders, using generalized estimating equations models. Subgroup analysis was performed according to gestational age (GA) groups. RESULTS Among 3383 eligible infants, 3222 were analyzed. The prevalence of PH was 6.0 % (95 % CI, 5.2-6.9), 14.5 % in infants born at 22-27+6 WG vs 2.7 % in infants born at 28-31+6 WG (P < .001). The primary outcome (survival without severe morbidity at discharge) occurred in 30.2 % of infants with PH vs 80.2 % of infants without PH (P < .001). Adjusted incidence rate ratios for survival without severe morbidity among infants with PH were 0.42 (0.32-0.57) and 0.52 (0.39-0.69) in infants born at 22-27+6 weeks gestation and those born at 28-31+6 weeks, respectively. Among infants with PH, 92.2 % (95 % CI, 87.7-95.2) received sedation and/or analgesia, 63.5 % (95 % CI, 56.6-69.9) received inhaled NO and 57.6 % (95 % CI, 50.9-64.0) received hemodynamic treatments. CONCLUSION In this population-based cohort of very preterm infants, the prevalence of PH was 6 %. PH was associated with a significant decrease of survival without severe morbidity in this population.
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Affiliation(s)
- Sophie Breinig
- Neonatal and Pediatric Intensive Care Unit, Children's Hospital, 330 Avenue de Grande-Bretagne, Toulouse Cedex 9, France; Center for Epidemiology and Research in POPulation health (CERPOP), UMR1295, Toulouse University, Inserm, Toulouse, France.
| | - Virginie Ehlinger
- Center for Epidemiology and Research in POPulation health (CERPOP), UMR1295, Toulouse University, Inserm, Toulouse, France
| | | | - Laurent Storme
- Neonatal Intensive Care Unit, Lille University Hospital, Lille, France
| | - Heloise Torchin
- Neonatal Intensive Care Unit, Maternité Cochin-Port Royal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Gilles Cambonie
- Neonatal and Pediatric Intensive Care Unit, Montpellier University Hospital, Montpellier, France
| | - Christophe Delacourt
- Department of Pediatric Pneumology, Necker Children's Hospital, Paris University Hospital, Paris, France
| | - Pierre-Henri Jarreau
- Neonatal Intensive Care Unit, Maternité Cochin-Port Royal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Lionel Berthomieu
- Neonatal and Pediatric Intensive Care Unit, Children's Hospital, 330 Avenue de Grande-Bretagne, Toulouse Cedex 9, France
| | - Olivier Brissaud
- Neonatal and Pediatric Intensive Care Unit, Bordeaux University Hospital, Bordeaux, France
| | - Valérie Benhammou
- INSERM, U1153, Obstetrical, Perinatal and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne, Paris, France
| | - Geraldine Gascoin
- Center for Epidemiology and Research in POPulation health (CERPOP), UMR1295, Toulouse University, Inserm, Toulouse, France; Neonatal Intensive Care Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Catherine Arnaud
- Center for Epidemiology and Research in POPulation health (CERPOP), UMR1295, Toulouse University, Inserm, Toulouse, France; Clinical Epidemiology Unit, Toulouse University Hospital, Toulouse, France
| | - Pierre-Yves Ancel
- INSERM, U1153, Obstetrical, Perinatal and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne, Paris, France
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Hurel C, Ehlinger V, Molcho M, Cohen JF, Falissard B, Sentenac M, Godeau E. Life satisfaction in the context of the COVID-19 pandemic among middle school adolescents in France: findings from a repeated cross-sectional survey (EnCLASS, 2012-2021). Front Pediatr 2023; 11:1204171. [PMID: 37614904 PMCID: PMC10443644 DOI: 10.3389/fped.2023.1204171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/07/2023] [Indexed: 08/25/2023] Open
Abstract
Background and aims Since the COVID-19 pandemic, several studies have reported a decrease in adolescents' well-being. We aim to describe life satisfaction over the last decade and examine the factors associated with its variations between 2020 and 2021 among French students in their last year of middle school (around 14-15 years old). Methods Data were drawn from a repeated biennial cross-sectional national survey conducted in French schools over the last decade (EnCLASS study), using a self-administered questionnaire. After describing life satisfaction trends between 2012 and 2021 using the Cantril ladder, we examined individual changes in life satisfaction between 2020 and 2021 and their associations with housing and studying conditions during the COVID-19 lockdown, using multinomial logistic regression analysis (decrease, increase, no change as reference). Results Among the 17,686 survey respondents, an overall slight decrease in the prevalence of adolescents reporting high life satisfaction (i.e., Cantril score ≥6) was observed since 2012 with the lowest proportion reported in 2021 (77.4%). Between 2020 and 2021, 16.3% of French adolescents experienced an improvement in life satisfaction, while 17.7% experienced the opposite. Decrease in life satisfaction between 2020 and 2021 was more likely experienced by adolescents living in reconstructed families [aOR 2.09 (95%CI, 1.58-2.77)], those who did not have their own room [aOR 1.58 (1.16-2.15)], nor access to the Internet to interact with their friends during the lockdown [aOR 1.47 (1.09-1.98)]. Interestingly, more girls than boys were represented in both those reporting increase and decrease in life satisfaction [aOR 1.82 (1.40-2.37) and 1.43 (1.14-1.79), respectively]. Conclusions This study shows that the way adolescents experienced the first 2020 lockdown in France was not uniform, and that one must consider sex as well as housing and studying conditions when interpreting adolescents' life satisfaction decrease during the COVID-19 pandemic.
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Affiliation(s)
- Cynthia Hurel
- Department of Human and Social Sciences, EHESP School of Public Health, Rennes, France
- Rennes University, Centre Hospitalier Universitaire (CHU) de Rennes, Department of Epidemiology and Public Health, Rennes, France
| | - Virginie Ehlinger
- UMR 1295 CERPOP, Inserm, Université Toulouse III - Paul Sabatier, Team SPHERE, Toulouse, France
| | - Michal Molcho
- Department of Children’s Studies, School of Education, University of Galway, Galway, Ireland
| | - Jérémie F. Cohen
- Department of General Pediatrics and Pediatric Infectious Diseases, Hôpital Necker-Enfants malades, AP-HP, Université Paris Cité, Paris, France
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Paris, France
| | - Bruno Falissard
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- Public Health and Epidemiology Department, AP-HP, Hôpital du Kremlin Bicêtre, Le Kremlin Bicêtre, France
| | - Mariane Sentenac
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Paris, France
| | - Emmanuelle Godeau
- Department of Human and Social Sciences, EHESP School of Public Health, Rennes, France
- UMR 1295 CERPOP, Inserm, Université Toulouse III - Paul Sabatier, Team SPHERE, Toulouse, France
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9
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Arnaud C, Ehlinger V, Perraud A, Kinsner-Ovaskainen A, Klapouszczak D, Himmelmann K, Petra M, Rackauskaite G, Lanzoni M, Platt MJ, Delobel-Ayoub M. Public health indicators for cerebral palsy: A European collaborative study of the Surveillance of Cerebral Palsy in Europe network. Paediatr Perinat Epidemiol 2023. [PMID: 36722642 DOI: 10.1111/ppe.12950] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/23/2022] [Accepted: 11/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Public health indicators (PHIs) play an increasingly important role in health policy decision-making. Although cerebral palsy (CP) is the commonest physical disability in children, its impact at population level has not been systematically measured so far. OBJECTIVES We aimed to propose six PHIs for CP designed to annually document the extent of CP and effectiveness of perinatal organisation, the burden of this condition, access to health services and preventive health strategies in the post-neonatal period and to report on the latest updated estimations using population-based data routinely collected by European CP registries. METHODS The study included children with CP born between 2002 and 2011. Harmonised data (number of cases, functional profile, imaging) were extracted from the Surveillance of Cerebral Palsy in Europe (SCPE) database. Eligibility criteria for analyses were applied separately for each indicator by selecting registries, birth years and CP cases. Current estimates were based on the last 3 birth years, while trends were reported over a 10-year period. All analyses were descriptive. Sensitivity analyses were carried out to examine the stability of the results using various thresholds of percentages of missing values. RESULTS Analyses were performed on a total of 8621 children with CP from 12 to 17 SCPE registries. A decreasing prevalence of pre/perinatal CP overall, as well as in preterm and full-term-born children, was observed. The burden of the condition was strongly dependent on CP subtype and the presence of associated impairments. Access to brain imaging ranged from 80% to 100% depending on registries. The overall prevalence of post-neonatally acquired CP was approximately 0.8 per 10,000 live births over the study period. CONCLUSIONS Population-based CP registries can provide data that are relevant for generating key outcomes of interest at the population level, thus potentially contributing to improving public health policies for children with disabilities.
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Affiliation(s)
- Catherine Arnaud
- CERPOP, UMR 1295 Toulouse University, Inserm, Paul Sabatier University, Toulouse, France.,Childhood Disability Registry in Haute-Garonne, University Hospital of Toulouse, Toulouse, France.,Clinical Epidemiology Unit, University Hospital of Toulouse, Toulouse, France
| | - Virginie Ehlinger
- CERPOP, UMR 1295 Toulouse University, Inserm, Paul Sabatier University, Toulouse, France.,Childhood Disability Registry in Haute-Garonne, University Hospital of Toulouse, Toulouse, France
| | - Annie Perraud
- European Commission, Joint Research Centre, Ispra, Italy
| | | | - Dana Klapouszczak
- CERPOP, UMR 1295 Toulouse University, Inserm, Paul Sabatier University, Toulouse, France.,Childhood Disability Registry in Haute-Garonne, University Hospital of Toulouse, Toulouse, France
| | - Kate Himmelmann
- Department of Pediatrics, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mariana Petra
- Department of Orthopaedics, General Hospital of Syros, Syros, Greece
| | - Gija Rackauskaite
- Child and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Monica Lanzoni
- European Commission, Joint Research Centre, Ispra, Italy
| | - Mary-Jane Platt
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Malika Delobel-Ayoub
- CERPOP, UMR 1295 Toulouse University, Inserm, Paul Sabatier University, Toulouse, France.,Childhood Disability Registry in Haute-Garonne, University Hospital of Toulouse, Toulouse, France
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10
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McIntyre S, Goldsmith S, Webb A, Ehlinger V, Hollung SJ, McConnell K, Arnaud C, Smithers‐Sheedy H, Oskoui M, Khandaker G, Himmelmann K. Global prevalence of cerebral palsy: A systematic analysis. Dev Med Child Neurol 2022; 64:1494-1506. [PMID: 35952356 PMCID: PMC9804547 DOI: 10.1111/dmcn.15346] [Citation(s) in RCA: 110] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 01/31/2023]
Abstract
AIM To determine trends and current estimates in regional and global prevalence of cerebral palsy (CP). METHOD A systematic analysis of data from participating CP registers/surveillance systems and population-based prevalence studies (from birth year 1995) was performed. Quality and risk of bias were assessed for both data sources. Analyses were conducted for pre-/perinatal, postnatal, neonatal, and overall CP. For each region, trends were statistically classified as increasing, decreasing, heterogeneous, or no change, and most recent prevalence estimates with 95% confidence intervals (CI) were calculated. Meta-analyses were conducted to determine current birth prevalence estimates (from birth year 2010). RESULTS Forty-one regions from 27 countries across five continents were represented. Pre-/perinatal birth prevalence declined significantly across Europe and Australia (11 out of 14 regions), with no change in postneonatal CP. From the limited but increasing data available from regions in low- and middle-income countries (LMICs), birth prevalence for pre-/perinatal CP was as high as 3.4 per 1000 (95% CI 3.0-3.9) live births. Following meta-analyses, birth prevalence for pre-/perinatal CP in regions from high-income countries (HICs) was 1.5 per 1000 (95% CI 1.4-1.6) live births, and 1.6 per 1000 (95% CI 1.5-1.7) live births when postneonatal CP was included. INTERPRETATION The birth prevalence estimate of CP in HICs declined to 1.6 per 1000 live births. Data available from LMICs indicated markedly higher birth prevalence. WHAT THIS PAPER ADDS • Birth prevalence of pre-/perinatal cerebral palsy (CP) in high-income countries (HICs) is decreasing. • Current overall CP birth prevalence for HICs is 1.6 per 1000 live births. • Trends in low- and middle-income countries (LMICs) cannot currently be measured. • Current birth prevalence in LMICs is markedly higher than in HICs. • Active surveillance of CP helps to assess the impact of medical advancements and social/economic development. • Population-based data on prevalence and trends of CP are critical to inform policy.
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Affiliation(s)
- Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and HealthThe University of SydneySydneyAustralia
| | - Shona Goldsmith
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and HealthThe University of SydneySydneyAustralia
| | - Annabel Webb
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and HealthThe University of SydneySydneyAustralia
| | - Virginie Ehlinger
- Center for Epidemiology and Research in Population health (CERPOP), InsermUniversity of ToulouseToulouseFrance
| | - Sandra Julsen Hollung
- Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP), Vestfold Hospital TrustTønsbergNorway
| | | | | | - Hayley Smithers‐Sheedy
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and HealthThe University of SydneySydneyAustralia
| | - Maryam Oskoui
- Department of Pediatrics, Faculty of Medicine and Health SciencesMcGill UniversityMontrealCanada
| | - Gulam Khandaker
- Central Queensland Hospital and Health ServiceRockhamptonAustralia
| | - Kate Himmelmann
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
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11
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Delobel-Ayoub M, Ehlinger V, Klapouszczak D, Duffaut C, Arnaud C, Sentenac M. Prevalence and characteristics of children with cerebral palsy according to socioeconomic status of areas of residence in a French department. PLoS One 2022; 17:e0268108. [PMID: 35588131 PMCID: PMC9119545 DOI: 10.1371/journal.pone.0268108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/23/2022] [Indexed: 11/19/2022] Open
Abstract
Aim
To study the association between the socioeconomic environment of area of residence and prevalence and characteristics of children with cerebral palsy (CP).
Method
Data on 8-year-old children with CP born in 2000–2011 (n = 252) were extracted from a regional population-based register in France. The European Deprivation Index (EDI), available at census block level, characterised socioeconomic deprivation in the child’s area of residence at age of registration. The prevalence of CP was estimated in each group of census units defined by EDI distribution tertiles in the general population. The association between deprivation level and CP severity was assessed according to term/preterm status.
Results
CP prevalence differed between deprivation risk groups showing a J-shaped form with the prevalence in the most deprived tertile (T3) being the highest but not significantly different of the prevalence in the least deprived one (T1). However, the prevalence in the medium deprivation tertile (T2) was significantly lower than that in the most deprived one with a prevalence risk ratio (PRR) of: PRRT2/T3 = 0.63 95% CI [0.44–0.89]). Prevalences of CP with associated intellectual disability (ID) and CP with inability to walk were significantly higher in the most deprived tertile compared to the least deprived one (respectively PRRT3/T1 = 1.86 95% CI [1.19–2.92] and PRRT3/T1 = 1.90 95% CI [1.07–3.37]). Compared to children living in the least deprived areas, children with CP born preterm living in the most deprived areas had more severe forms of motor impairment, such as an inability to walk or a combination of an inability to walk and moderate to severe impairment of bimanual function. They also had more associated intellectual disability. No associations were observed among term-born children.
Interpretation
A significant association between area deprivation group and CP severity was observed among preterm children but not among term-born children.
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Affiliation(s)
- Malika Delobel-Ayoub
- CERPOP, UMR1295 Toulouse University, Inserm, Paul Sabatier University, Toulouse, France
- CHU Toulouse, Registre des Handicaps de l’Enfant en Haute-Garonne, Toulouse, France
- * E-mail:
| | - Virginie Ehlinger
- CERPOP, UMR1295 Toulouse University, Inserm, Paul Sabatier University, Toulouse, France
- CHU Toulouse, Registre des Handicaps de l’Enfant en Haute-Garonne, Toulouse, France
| | - Dana Klapouszczak
- CERPOP, UMR1295 Toulouse University, Inserm, Paul Sabatier University, Toulouse, France
- CHU Toulouse, Registre des Handicaps de l’Enfant en Haute-Garonne, Toulouse, France
| | - Carine Duffaut
- CERPOP, UMR1295 Toulouse University, Inserm, Paul Sabatier University, Toulouse, France
| | - Catherine Arnaud
- CERPOP, UMR1295 Toulouse University, Inserm, Paul Sabatier University, Toulouse, France
- CHU Toulouse, Registre des Handicaps de l’Enfant en Haute-Garonne, Toulouse, France
- Clinical Epidemiology Unit, University Hospital, Toulouse, France
| | - Mariane Sentenac
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Paris, France
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12
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Akel M, Sakr F, Fahs I, Dimassi A, Dabbous M, Ehlinger V, Salameh P, Godeau E. Smoking Behavior among Adolescents: The Lebanese Experience with Cigarette Smoking and Waterpipe Use. Int J Environ Res Public Health 2022; 19:5679. [PMID: 35565073 PMCID: PMC9105385 DOI: 10.3390/ijerph19095679] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/25/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022]
Abstract
(1) Background: The study aims to assess cigarette smoking and waterpipe experimentation among Lebanese adolescent school students with respect to their gender, region, age, and socioeconomic status. (2) Methods: This is a cross-sectional study, where students between 11 to 18 years of age were included from all over Lebanon. (3) Results: A total of 1133 students were interviewed. The total proportion of adolescents who ever experimented with cigarette smoking was 24.5%. Males experimented with cigarette smoking more commonly than females (31.9% vs. 19.1%; p < 0.001). Cigarette smoking experimentation was higher among students from the Beirut area (33.6%; p < 0.001) in comparison to other regions, and among those with poor health perception (29.1% vs. 19.8%; p < 0.001) compared to students with excellent health perception. The total proportion of adolescents who ever used a waterpipe was 33.9%. Waterpipes were significantly more experimented with among males than females (40.3% vs. 29.8%; p < 0.001), and among students with bad perception about their health (39.4% vs. 28.9%; p < 0.001). Adolescents who experimented with both cigarettes and waterpipes constitute 22.2% of the studied sample. (4) Conclusions: The rate of tobacco product use is alarming and constitutes a major public health issue for adolescents that urgently needs intervention. The findings raise important policy implications for the development of cigarette smoking prevention programs for youth.
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Affiliation(s)
- Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut 1103, Lebanon; (M.A.); (I.F.); (A.D.); (M.D.)
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 6573, Lebanon;
- International Pharmaceutical Federation (FIP), 2517 The Hague, The Netherlands
- UMR 1295 CERPOP (Centre for Epidemiology and Research in Population Health), INSERM, Toulouse University III Paul Sabatier, Team SPHERE, 31059 Toulouse, France; (V.E.); (E.G.)
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut 1103, Lebanon; (M.A.); (I.F.); (A.D.); (M.D.)
- INSERM U955, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, 94000 Créteil, France
| | - Iqbal Fahs
- School of Pharmacy, Lebanese International University, Beirut 1103, Lebanon; (M.A.); (I.F.); (A.D.); (M.D.)
| | - Ahmad Dimassi
- School of Pharmacy, Lebanese International University, Beirut 1103, Lebanon; (M.A.); (I.F.); (A.D.); (M.D.)
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut 1103, Lebanon; (M.A.); (I.F.); (A.D.); (M.D.)
- School of Education, Lebanese International University, Beirut 1103, Lebanon
| | - Virginie Ehlinger
- UMR 1295 CERPOP (Centre for Epidemiology and Research in Population Health), INSERM, Toulouse University III Paul Sabatier, Team SPHERE, 31059 Toulouse, France; (V.E.); (E.G.)
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 6573, Lebanon;
- Faculty of Public Health, Lebanese University, Beirut 6573, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia 2408, Cyprus
| | - Emmanuelle Godeau
- UMR 1295 CERPOP (Centre for Epidemiology and Research in Population Health), INSERM, Toulouse University III Paul Sabatier, Team SPHERE, 31059 Toulouse, France; (V.E.); (E.G.)
- Ecole des Hautes Etudes en Sante Publique, 35043 Rennes, France
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13
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Groussolles M, Winer N, Sentilhes L, Biquart F, Massoud M, Vivanti AJ, Bouchghoul H, Rozenberg P, Olivier P, Desbriere R, Chauleur C, Perrotin F, Coatleven F, Fuchs F, Bretelle F, Tsatsaris V, Salomon LJ, Sananes N, Kayem G, Houflin-Debarge V, Schmitz T, Benoist G, Arnaud C, Ehlinger V, Vayssière C. Arabin pessary to prevent adverse perinatal outcomes in twin pregnancies with a short cervix: a multicenter randomized controlled trial (PESSARONE). Am J Obstet Gynecol 2022; 227:271.e1-271.e13. [PMID: 35123930 DOI: 10.1016/j.ajog.2022.01.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 01/17/2022] [Accepted: 01/28/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The number of twin pregnancies continues to increase worldwide as both the number of pregnancies obtained by medically assisted reproduction and age at first pregnancy keep rising. Preterm delivery is the major complication associated with twin pregnancies. The effectiveness of preventive treatments such as progesterone or cervical cerclage for women with a short cervix is doubtful in twin pregnancies. The effectivity of cervical pessaries in preventing preterm birth and its associated morbidity and mortality is also controversial. OBJECTIVE We sought to investigate if the Arabin pessary reduces adverse neonatal outcomes in twin pregnancies with a short cervix. STUDY DESIGN This open-label, multicenter, randomized controlled trial on twin pregnancies with a cervical length of <35 mm compared pessary placement at 16+0 to 24+0 weeks' gestation with standard care alone. The primary endpoint was a composite of adverse neonatal outcomes, namely peripartum or neonatal death or significant neonatal morbidity before hospital discharge, defined as at least 1 of the following complications: bronchopulmonary dysplasia, intraventricular hemorrhage grade III to IV, periventricular leukomalacia, necrotizing enterocolitis grade II or higher, culture-proven sepsis, and retinopathy requiring treatment. A sample size of 308 pregnancies was planned to ensure 80% power to compare the proportions of women with at least 1 infant with an adverse neonatal outcome. The intention-to-treat analysis after multiple imputation of missing data, was supplemented with a secondary analysis that controlled for gestational age and cervical length, both at inclusion. The primary endpoint was also compared between randomization groups in the per-protocol population, which excluded patients with prespecified major protocol violations (mostly cervical cerclage and/or progesterone after inclusion). Secondary endpoints included preterm birth, spontaneous preterm birth, and pessary side effects. RESULTS In total, 315 women were randomized to either receive a pessary (n=157) or standard management (n=158). Overall, 10.8% (34 women) of participants had a missing value for the primary endpoint, mostly (79%) because of the lack of paternal consent for neonatal data collection. In the intention-to-treat analysis, the adverse neonatal outcome occurred in 16.8% of the pessary group vs in 22.5% of the control group (risk ratio, 0.69; 95% confidence interval, 0.39-1.23; P=.210). The per-protocol analysis did not show any significant difference between groups (risk ratio, 0.78; 95% confidence interval, 0.47-1.28; P=.320). The occurrence of preterm birth or spontaneous preterm birth did not differ significantly between groups. No serious side effects were associated with pessary use. CONCLUSION Pessary use in our study did not significantly reduce adverse neonatal outcomes in twin pregnancies with a short cervix.
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14
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Vidart d'Egurbide Bagazgoïtia N, Ehlinger V, Duffaut C, Fauconnier J, Schmidt-Schuchert S, Thyen U, Himmelmann K, Marcelli M, Arnaud C. Quality of Life in Young Adults With Cerebral Palsy: A Longitudinal Analysis of the SPARCLE Study. Front Neurol 2021; 12:733978. [PMID: 34790161 PMCID: PMC8591289 DOI: 10.3389/fneur.2021.733978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/10/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: While most people with cerebral palsy (CP) will have a life expectancy similar to that of the general population, international research has primarily focused on childhood and adolescence; and knowledge about the quality of life (QoL) of young adults with CP, its trajectories, and associated factors remains scarce. Methods: This longitudinal study included young adults with CP living in five European regions and who had previously participated in the SPARCLE cohort as children and/or adolescents. Their QoL in the psychological well-being and social relationships domains was estimated using age-appropriate validated instruments (KIDSCREEN-52 in childhood/adolescence and WHOQOL-Bref in young adulthood). We used generalized linear mixed-effect models with random intercept to estimate long-term trajectories of QoL in both domains and to investigate whether severity of impairment, pain, and seizure influenced these trajectories. We sought to identify potentially different trajectories of QoL from childhood to adulthood using a shape-based clustering method. Results: In total, 164 young adults with CP aged 22–27 years participated in the study. Psychological well-being linearly decreased by 0.78 points (scale 0–100) per year (95% confidence interval (CI) −0.99 to −0.56) from childhood to young adulthood, whereas QoL in the social relationships domain increased (β coefficient 1.24, 95% CI 0.92–1.55). Severity of impairment was associated with reduced QoL in all life periods of the study (childhood, adolescence, and young adulthood): motor impairment with social relationships, and more nuancedly intellectual disability with psychological well-being and social relationships. At all periods, frequent pain significantly reduced psychological well-being, and seizures were associated with lower QoL in the social relationships domain. In both domains, we identified a group of individuals with CP who presented a reverse trajectory compared with the general QoL trajectory. Conclusion: Identification of QoL trajectories and their associated factors yields improved knowledge about the experience of individuals with CP until young adulthood. Further studies are needed to better understand the determinants that have the greatest influence on the different shapes of long-term trajectories of QoL.
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Affiliation(s)
| | - Virginie Ehlinger
- UMR 1295 CERPOP, Inserm, Toulouse University III Paul Sabatier, Team SPHERE, Toulouse, France
| | - Carine Duffaut
- UMR 1295 CERPOP, Inserm, Toulouse University III Paul Sabatier, Team SPHERE, Toulouse, France
| | - Jérôme Fauconnier
- Laboratory TIMC-IMAG, Grenoble Alpes University, Department UFR Medicine, Grenoble, France
| | - Silke Schmidt-Schuchert
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - Ute Thyen
- Klinik für Kinder und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
| | - Kate Himmelmann
- Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marco Marcelli
- Azienda Sanitaria Locale Viterbo, Child and Adolescent Neuropsychiatric Unit-Adult Disability Unit, Viterbo, Italy
| | - Catherine Arnaud
- UMR 1295 CERPOP, Inserm, Toulouse University III Paul Sabatier, Team SPHERE, Toulouse, France.,Clinical Epidemiology Unit, University Hospital, Toulouse, France
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15
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Losbar JL, Montjaux N, Ehlinger V, Germany L, Arnaud C, Tscherning C. Early discharge and hospital-assisted home care is associated with better neurodevelopmental outcome in preterm infants. Early Hum Dev 2021; 161:105451. [PMID: 34507020 DOI: 10.1016/j.earlhumdev.2021.105451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/24/2021] [Accepted: 08/09/2021] [Indexed: 11/26/2022]
Abstract
AIMS To compare hospital-assisted neonatal home care and standard hospital care for preterm newborns on neurodevelopment at 2 years corrected age, as well as duration of hospitalization, breastmilk rates, and readmissions before 1 year. METHODS This observational study enrolled 415 inborn neonates <34+ 6 weeks that received home care (2008 to 2015) in the French University Hospital of Toulouse and 3186 neonates from the national cohort of infants discharged in 2011 that received standard hospital neonatal care (EPIPAGE 2). Neurodevelopment at 2 years was assessed with the Ages and Stages Questionnaire-3 (ASQ-3). RESULTS At two years corrected age, infants in home care had 61% less risk of overall low ASQ ≤220 (OR = 0.4 [0.3-0.5], p < 0.001) and 31-80% less risk of low scores in four out of five domains compared to standard care. Home care was associated with shorter hospital stays (- 9 days; p < 0.001), higher breastmilk rates at final discharge (OR = 3.6 [2.8-4.6], p < 0.001 for singletons and OR = 2.3 [1.6-3.1], p < 0.001 for multiples), and more breastmilk feeding for at least six months (OR = 1.8 [1.3-2.3], p < 0.001 for singletons, OR = 3.6 [2.1-6.3], p < 0.001 for multiples). Readmissions also occurred less frequently with home care than with standard care, except for twins (OR = 0.7 [0.6-0.8], p < 0.001). CONCLUSION Hospital-assisted neonatal home care for preterm infants was associated with better neurodevelopment at 2 years corrected age, shorter duration of hospitalization, and higher rates of breastmilk feeding at 6 months.
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Affiliation(s)
| | - Nathalie Montjaux
- Department of Neonatal Medicine, Children's Hospital, Toulouse, France
| | - Virginie Ehlinger
- Center for Epidemiology and Research in POPulation health (CERPOP), Toulouse University, Inserm, UPS, Toulouse, France
| | - Laurence Germany
- INSERM, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), F-94807, Villejuif, France
| | - Catherine Arnaud
- Center for Epidemiology and Research in POPulation health (CERPOP), Toulouse University, Inserm, UPS, Toulouse, France; Clinical Epidemiology Unit, Toulouse University Hospital, Toulouse, France
| | - Charlotte Tscherning
- Université de Toulouse III, Toulouse, France; Division of Neonatology, Sidra Medecine, Weill Cornell Medical College, Doha, Qatar; Centre of Physiopathology Toulouse-Purpan (CPTP), Inserm, CNRS, University of Toulouse, France
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16
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Arnaud C, Duffaut C, Fauconnier J, Schmidt S, Himmelmann K, Marcelli M, Pennington L, Alvarelhão J, Cytera C, Rapp M, Ehlinger V, Thyen U. Determinants of participation and quality of life of young adults with cerebral palsy: longitudinal approach and comparison with the general population - SPARCLE 3 study protocol. BMC Neurol 2021; 21:254. [PMID: 34193065 PMCID: PMC8244176 DOI: 10.1186/s12883-021-02263-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 06/02/2021] [Indexed: 12/20/2022] Open
Abstract
Background Effective inclusion in society for young people with disabilities is increasingly seen as generating opportunities for self-development, and improving well-being. However, significant barriers remain in the vast majority of activities meaningful for young adults. Research argues that various personal (disabilities, health) and environmental (access to the resources needed, accessible environment, discrimination, lack of personal economic independence) factors contribute to limited participation. However, previous studies conducted in young people with cerebral palsy (CP) mainly investigated the transition period to adulthood, and did not fully consider the whole range of impairment severity profiles or environmental barriers. In this study, we will use the follow-up of the SPARCLE cohort and a comparison group from the general population (1) to investigate the impact of the environment on participation and quality of life of young adults with CP, (2) to determine predictors of a successful young adulthood in educational, professional, health and social fields, (3) to compare quality of life and frequency of participation in social, work and recreational activities with the general population, (4) to document on participation and quality of life in those with severe disabilities. Methods The SPARCLE3 study has a combined longitudinal and cross-sectional design. Young adults with CP aged 22 to 27 years in 6 European regions previously enrolled in the SPARCLE cohort or newly recruited will be invited to self-complete a comprehensive set of questionnaires exploring participation (daily life and discretionary activities), health-related quality of life, body function, personal factors (health, personal resources), and contextual factors (availability of needed environmental items, family environment, services provision) during home visits supervised by trained researchers. Proxy-reports or adapted questionnaires will be used for those with the most severe impairments. The recruitment of a large group from the general population (online survey) will enable to identify life areas where the discrepancies between young people with CP and their able-bodied peers are the most significant. Discussion This study will help identify to what extent disabilities and barriers in environment negatively affect participation and quality of life, and how previous valued experiences during childhood or adolescence might modulate these effects.
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Affiliation(s)
- Catherine Arnaud
- UMR 1027 Inserm, Toulouse3 University, team Sphere, Hôpital Paule de Viguier, 330 Avenue de Grande Bretagne, TSA 70034, F-31059, Toulouse, France. .,Clinical Epidemiology Unit, University Hospital, F-31059, Toulouse, France.
| | - Carine Duffaut
- UMR 1027 Inserm, Toulouse3 University, team Sphere, Hôpital Paule de Viguier, 330 Avenue de Grande Bretagne, TSA 70034, F-31059, Toulouse, France
| | - Jérôme Fauconnier
- Laboratoire TIMC-IMAG Equipe ThEMAS, Grenoble Alpes University, Pavillon Taillefer CHU Grenoble CS10217, F-338043, Grenoble, France
| | - Silke Schmidt
- University of Greifswald, Institute of Psychology, Robert-Blum-Str. 13, 17489, Greifswald, Germany
| | - Kate Himmelmann
- Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Marco Marcelli
- Azienda Sanitaria Locale Viterbo, Child and Adolescent Neuropsychiatric Unit - Adult Disability Unit, Via Enrico Fermi 15, 01100, Viterbo, Italy
| | - Lindsay Pennington
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Joaquim Alvarelhão
- School of Health Sciences, University of Aveiro, Campo Universitário de Santiago, Aveiro, Portugal
| | - Chirine Cytera
- University of Greifswald, Institute of Psychology, Robert-Blum-Str. 13, 17489, Greifswald, Germany.,Department of Pediatric and Adolescent Medicine, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Marion Rapp
- Department of Pediatric and Adolescent Medicine, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Virginie Ehlinger
- UMR 1027 Inserm, Toulouse3 University, team Sphere, Hôpital Paule de Viguier, 330 Avenue de Grande Bretagne, TSA 70034, F-31059, Toulouse, France
| | - Ute Thyen
- Department of Pediatric and Adolescent Medicine, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
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17
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Arnaud C, Ehlinger V, Delobel-Ayoub M, Klapouszczak D, Perra O, Hensey O, Neubauer D, Hollódy K, Virella D, Rackauskaite G, Greitane A, Himmelmann K, Ortibus E, Dakovic I, Andersen GL, Papavasiliou A, Sellier E, Platt MJ, Krägeloh-Mann I. Trends in Prevalence and Severity of Pre/Perinatal Cerebral Palsy Among Children Born Preterm From 2004 to 2010: A SCPE Collaboration Study. Front Neurol 2021; 12:624884. [PMID: 34093391 PMCID: PMC8173253 DOI: 10.3389/fneur.2021.624884] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/13/2021] [Indexed: 11/18/2022] Open
Abstract
Aim: To report on prevalence of cerebral palsy (CP), severity rates, and types of brain lesions in children born preterm 2004 to 2010 by gestational age groups. Methods: Data from 12 population-based registries of the Surveillance of Cerebral Palsy in Europe network were used. Children with CP were eligible if they were born preterm (<37 weeks of gestational age) between 2004 and 2010, and were at least 4 years at time of registration. Severity was assessed using the impairment index. The findings of postnatal brain imaging were classified according to the predominant pathogenic pattern. Prevalences were estimated per 1,000 live births with exact 95% confidence intervals within each stratum of gestational age: ≤27, 28–31, 32–36 weeks. Time trends of both overall prevalence and prevalence of severe CP were investigated using multilevel negative binomial regression models. Results: The sample comprised 2,273 children. 25.8% were born from multiple pregnancies. About 2-thirds had a bilateral spastic CP. 43.5% of children born ≤27 weeks had a high impairment index compared to 37.0 and 38.5% in the two other groups. Overall prevalence significantly decreased (incidence rate ratio per year: 0.96 [0.92–1.00[) in children born 32–36 weeks. We showed a decrease until 2009 for children born 28–31 weeks but an increase in 2010 again, and a steady prevalence (incidence rate ratio per year = 0.97 [0.92–1.02] for those born ≤27 weeks. The prevalence of the most severely affected children with CP revealed a similar but not significant trend to the overall prevalence in the corresponding GA groups. Predominant white matter injuries were more frequent in children born <32 weeks: 81.5% (≤27 weeks) and 86.4% (28–31 weeks), compared to 63.6% for children born 32–36 weeks. Conclusion: Prevalence of CP in preterm born children continues to decrease in Europe excepting the extremely immature children, with the most severely affected children showing a similar trend.
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Affiliation(s)
- Catherine Arnaud
- UMR 1027 SPHERE Team, Inserm, Toulouse 3 Paul Sabatier University, Toulouse, France.,Childhood Disability Registry in Haute-Garonne, University Hospital of Toulouse, Toulouse, France.,Clinical Epidemiology Unit, University Hospital of Toulouse, Toulouse, France
| | - Virginie Ehlinger
- UMR 1027 SPHERE Team, Inserm, Toulouse 3 Paul Sabatier University, Toulouse, France.,Childhood Disability Registry in Haute-Garonne, University Hospital of Toulouse, Toulouse, France
| | - Malika Delobel-Ayoub
- UMR 1027 SPHERE Team, Inserm, Toulouse 3 Paul Sabatier University, Toulouse, France.,Childhood Disability Registry in Haute-Garonne, University Hospital of Toulouse, Toulouse, France
| | - Dana Klapouszczak
- UMR 1027 SPHERE Team, Inserm, Toulouse 3 Paul Sabatier University, Toulouse, France.,Childhood Disability Registry in Haute-Garonne, University Hospital of Toulouse, Toulouse, France
| | - Oliver Perra
- School of Nursing & Midwifery and Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, United Kingdom
| | | | - David Neubauer
- Department of Child, Adolescent & Developmental Neurology, University Children's Hospital Ljubljana, Ljubljana, Slovenia
| | - Katalin Hollódy
- Department of Paediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Daniel Virella
- Neonatology Intensive Care Unit/Research Center, Central Lisbon Hospital, Lisbon, Portugal
| | - Gija Rackauskaite
- Child and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | - Kate Himmelmann
- Department of Pediatrics, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Els Ortibus
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Ivana Dakovic
- Children's Hospital Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - Guro L Andersen
- The Norwegian University of Science and Technology, NTNU, Trondheim, Norway.,The Cerebral Palsy Register of Norway, Vestfold Hospital Trust, Tønsberg, Norway
| | | | - Elodie Sellier
- Grenoble Alpes University, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC-IMAG, Grenoble, France.,Registre des Handicaps de l'Enfant et Observatoire Périnatal, Grenoble, France
| | - Mary Jane Platt
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Inge Krägeloh-Mann
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital, Eberhard Karls Universität Tübingen, Tübingen, Germany
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18
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Breinig S, Dicky O, Ehlinger V, Dulac Y, Marcoux MO, Arnaud C. Echocardiographic Parameters Predictive of Poor Outcome in Persistent Pulmonary Hypertension of the Newborn (PPHN): Preliminary Results. Pediatr Cardiol 2021; 42:1848-1853. [PMID: 34331558 PMCID: PMC8324438 DOI: 10.1007/s00246-021-02677-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/30/2021] [Indexed: 12/01/2022]
Abstract
The aim is to conduct a pilot study to prospectively describe echocardiographic parameters in neonates with pulmonary hypertension (PH) managed according to current recommendations and to identify those parameters that could predict worsening of short-term outcomes. All neonates less than 28 days old with a diagnosis of PH were prospectively enrolled in a tertiary care center for 1 year. Two echocardiograms were performed by a trained neonatologist. The first echocardiogram was performed at the time of diagnosis, whereas the second was performed just after basic therapeutic optimization. The cohort included 27 neonates. Mean gestational age at birth was 36.1 weeks gestational age (WGA) (SD: 4) and mean birth weight was 2658 g (SD: 907). Six neonates (22%) died before day 28, with a median age at death of 48 h (IQR [33; 89]). Although the first echocardiogram showed no difference, the second highlighted a strong link between the persistence of right-to left-shunt and death (p = 0.002). We showed a link between right-to-left shunt and a poor outcome (death or morbidity) after therapeutic optimization among premature and full-term neonates suffering from PH. We recommend repeating echocardiography after basic therapeutic optimization and for prognostic purposes, taking into account only the second examination. Larger cohorts are needed to confirm these results.
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Affiliation(s)
- Sophie Breinig
- Neonatal and Pediatric Intensive Care Unit, Children's Hospital, 330 Avenue de Grande-Bretagne, Toulouse Cedex 9, France. .,INSERM, UMR 1027, SPHERE Team, Hôpital Paule de Viguier, 330 Avenue de Grande-Bretagne, TSA 70034, Toulouse, France.
| | - Odile Dicky
- grid.414260.50000 0004 0638 3516INSERM, UMR 1027, SPHERE Team, Hôpital Paule de Viguier, 330 Avenue de Grande-Bretagne, TSA 70034, Toulouse, France ,Neonatal Intensive Care Unit, Children’s Hospital, 330 Avenue de Grande-Bretagne, Toulouse Cedex 9, France
| | - Virginie Ehlinger
- grid.414260.50000 0004 0638 3516INSERM, UMR 1027, SPHERE Team, Hôpital Paule de Viguier, 330 Avenue de Grande-Bretagne, TSA 70034, Toulouse, France
| | - Yves Dulac
- Pediatric Cardiology, Children’s Hospital, 330 Avenue de Grande-Bretagne, Toulouse Cedex 9, France
| | - Marie-Odile Marcoux
- Neonatal and Pediatric Intensive Care Unit, Children’s Hospital, 330 Avenue de Grande-Bretagne, Toulouse Cedex 9, France
| | - Catherine Arnaud
- grid.414260.50000 0004 0638 3516INSERM, UMR 1027, SPHERE Team, Hôpital Paule de Viguier, 330 Avenue de Grande-Bretagne, TSA 70034, Toulouse, France ,grid.411175.70000 0001 1457 2980Clinical Epidemiology Unit, University Hospital Toulouse, 37 Allées Jules Guesde, 31000 Toulouse, France
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19
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Sentenac M, Rapp M, Ehlinger V, Colver A, Thyen U, Arnaud C. Disparity of child/parent-reported quality of life in cerebral palsy persists into adolescence. Dev Med Child Neurol 2021; 63:68-74. [PMID: 32710687 DOI: 10.1111/dmcn.14638] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2020] [Indexed: 01/10/2023]
Abstract
AIM To examine the evolution of child-parent discrepancy in reporting quality of life (QoL) between childhood and adolescence in children with cerebral palsy (CP) and to investigate potential factors associated with such a discrepancy. METHOD We used data from the SPARCLE (Study of PARticipation of Children with CP Living in Europe) study, a population-based cohort study of children with CP, aged 8 to 12 years at baseline (in 2004-2005), in nine European centres, who were followed up at the age of 13 to 17 years. The KIDSCREEN-52 Quality of Life measure was used at baseline and follow-up; 354 child-parent dyads out of 500 eligible dyads were followed up (201 males, 153 females). We used intraclass correlation coefficients (ICCs) to examine agreement between parent proxy-reports and self-reported QoL. We used linear regression to examine factors associated with child-parent discrepancy in QoL reporting. RESULTS Agreement was low to moderate (ICC=0.16-0.48) in childhood and in adolescence across all QoL domains. In four domains (moods and emotions, self-perception, relationship with parents and home life, and social support and peers), the extent of the discrepancy increased significantly between childhood and adolescence. Parenting stress, child pain, and child behaviour problems influenced parent proxy-reports during both childhood and adolescence. INTERPRETATION The points of view of the child and their parents should be treated as complementary to obtain better knowledge regarding the QoL of children and adolescents with CP.
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Affiliation(s)
| | - Marion Rapp
- Klinik für Kinder und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
| | | | - Allan Colver
- Institute of Health and Society, Royal Victoria Infirmary, Newcastle University, Newcastle upon Tyne, UK
| | - Ute Thyen
- Klinik für Kinder und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
| | - Catherine Arnaud
- Inserm U1027, Université Paul Sabatier, Toulouse, France.,Clinical Epidemiology Unit, CHU Purpan, Toulouse, France
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20
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Akel M, Salameh P, Ehlinger V, Godeau E. The emergency to tackle tobacco smoking by Lebanese adolescents. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
In Lebanon, tobacco use by adolescents remains a problem and is higher than among adults. This study sought to assess the experimentation of tobacco smoking practices among adolescents in Lebanon, and further to link health promotion at school-level (measured with the Hat Questionnaire) to the smoking behaviour at students-level (measured with the HBSC questionnaire). We relied on a cross-sectional observational study, conducted in 50 schools across Lebanon. The students' ages ranged from 11 to 18 years old (6th to 12th grade). They filled-in a confidential, anonymous self-questionnaire in class. In parallel, the school administration filled in the assessment questionnaire for health promotion. STATA Software was used for statistical analysis.7133 students were included (mean age 15.24±2.00 years). Overall, 24.5% had ever experimented cigarette smoking alone, boys more than girls (31.95% vs. 19.14%; p < 0.001), mainly from Beirut (33.62%; p < 0.001) and with poor health perception (29.12% vs. 19.87%; p < 0.001). Overall, 33.98% had ever used water-pipe alone, again more boys (40.34% vs. 29.88%; p < 0.001), from Beirut (39.55%, p < 0.001), and with poor health perception (39.48% vs. 28.93%; p < 0.001). Finally, 22.28% experimented both cigarettes and water-pipe. Around 70% of the involved schools offered health-related courses in their curricula. 72 % of them included interventions on the harm of smoking but not as an integral part of the curriculum. Less than half of them had developed plans to improve health promotion and review data to ensure the effectiveness of their programs. This alarming rate of use of tobacco products constitutes a major public health issue for Lebanese adolescents that needs urgent intervention. Further analysis will focus on the school-level questionnaires. Already our results will serve to foster the reinforcement of health promoting schools in Lebanon by the ministry of Education, in line with international recommendations.
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Affiliation(s)
- M Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- UMR1027, équipe SPHERE, INSERM, Toulouse, France
| | - P Salameh
- INSPECT-LB, Lebanese University, Beirut, Lebanon
| | - V Ehlinger
- UMR1027, équipe SPHERE, INSERM, Toulouse, France
| | - E Godeau
- EHESP, Rennes, France
- UMR1027, équipe SPHERE, INSERM, Toulouse, France
- Arènes - UMR CNRS 6051, CNRS, Rennes, France
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21
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Godeau E, Spilka S, Ehlinger V, Philippon A, Lenezet O. When merging two international surveys (HBSC/ESPAD) leads to better monitoring at national level. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
In France, since 1994, adolescents' substance use was measured among 11-13-15 year-olds with the Health Behavior in School-aged Children (HBSC) & among 16-year-olds with the European School Project on Alcohol and other Drugs (ESPAD). Since 2018, with EnCLASS, (National Survey in Middle- and High-school for Adolescents on Health and Substances), France conducts those 2 surveys in a unified way across middle- & high-school, improving the monitoring of health behaviours, substance use included throughout adolescence at national level, while ensuring optimum comparability internationally. Our paper will summarise substance use by secondary students in France with a focus on preventive interventions on substances organised in class. Data collected in 2018 in 1137 classes; nationally representative sample of 20 128 secondary-school students (grade 6-12); confidential & anonymous online self-questionnaire. Schools, parents & students could refuse to participate. Inclusion rate: 74%. Secondary school is the main period where alcohol, tobacco & cannabis are experimented. With subsequent timing: Alcohol, mainly initiated during middle school, is still the first substance used during adolescence, followed by tobacco. The consumption of cannabis tends to begin at the end of middle school, with experimentation & use developing & strengthening during high school. Overall, 10% of 6th grade students report having had an intervention on substance use, up to half in 9th grade. Regarding speakers, 1/2 report external experts, 1/3 teachers & 1/4 school nurses. It seems that alcohol, tobacco & cannabis are discussed at the same occasion. Such findings show a rather good coherence between school intervention & prevalence of substance use EnCLASS by merging HBSC & ESPAD ensures an excellent comparability of data internationally while providing a strong national monitoring of French adolescents' substance use throughout secondary school.
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Affiliation(s)
- E Godeau
- EHESP, Rennes, France
- UMR1027, SPHERE, INSERM, Toulouse, France
- Arènes - UMR CNRS 6051, CNRS, Rennes, France
| | - S Spilka
- French Monitoring Centre for Drugs and Drug Addiction, Paris, France
- CESP, Faculté de médecine, Université Paris Sud, Villejuif, France
| | - V Ehlinger
- UMR1027, SPHERE, INSERM, Toulouse, France
| | - A Philippon
- French Monitoring Centre for Drugs and Drug Addiction, Paris, France
- CESP, Faculté de médecine, Université Paris Sud, Villejuif, France
| | - O Lenezet
- French Monitoring Centre for Drugs and Drug Addiction, Paris, France
- CESP, Faculté de médecine, Université Paris Sud, Villejuif, France
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22
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Morin M, Claris O, Dussart C, Frelat A, De Place A, Molinier L, Matillon Y, Ehlinger V, Vayssiere C. Quality of Life During Pregnancy: Is There a Link with Breastfeeding at Birth? Breastfeed Med 2020; 15:321-330. [PMID: 32091916 DOI: 10.1089/bfm.2019.0123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: In France, the proportion of children who are exclusively breastfed has been decreasing in recent years. The aim of the study is to assess the link between quality of life (QOL) in pregnant women from the first trimester to the end of pregnancy using the French version EQ5D-3L questionnaire and the feeding method at birth (breast or bottle). Materials and Methods: Five hundred pregnant adult women were monitored between 2015 and 2017 at the Toulouse University Hospital (France). The data were collected monthly. After analyzing the QOL (EQ-5D-Index) and health status (EQ-5D-Visual Analogue Scale) for 1 month, we carried out a nine-group category analysis based on their QOL in the third month (low QOL [score <0.50 out of 1], intermediate [score between 0.50 and 0.90 out of 1], or high [score ≥0.90 out of 1]) and then based on changes in their QOL between the third and eighth month [marked reduction (low >0.6 point), intermediate (low between 0.1 and 0.6 point), and slight reduction (low <0.1 points increase)]. Results: Around1,847 questionnaires were collected and analyzed from 500 women. The monthly analysis did not highlight any link between QOL or health status reported during pregnancy and the feeding method at birth. As regard to the category analysis, following adjustment, the logistic regression model shows that breastfeeding is not linked to QOL in the third month of pregnancy (p = 0.171) or to changes in QOL during pregnancy (p = 0.426). However, there is less of a tendency to breastfeed in individuals with a high QOL in the third month of pregnancy compared to an intermediate QOL during the third month of pregnancy (p = 0.06). Conclusion: In this cohort of pregnant women for whom QOL was assessed throughout pregnancy, no link between QOL and feeding method was highlighted.
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Affiliation(s)
- Mathieu Morin
- Department of Obstetrics and Gynaecology, Toulouse University Hospital, Toulouse, France.,Department of Pathways to Systemic Health-P2S-EA 4129, University Claude Bernard Lyon I, Lyon, France
| | - Olivier Claris
- Department of Pathways to Systemic Health-P2S-EA 4129, University Claude Bernard Lyon I, Lyon, France.,Department of Neonatolgy and Neonatal Intensive Care, Lyon University Hospital, Lyon, France
| | - Claude Dussart
- Department of Pathways to Systemic Health-P2S-EA 4129, University Claude Bernard Lyon I, Lyon, France
| | - Alais Frelat
- Department of Obstetrics and Gynaecology, Toulouse University Hospital, Toulouse, France
| | - Alice De Place
- Department of Obstetrics and Gynaecology, Toulouse University Hospital, Toulouse, France
| | - Laurent Molinier
- Department of Medical Information, Toulouse University Hospital, Toulouse, France.,Research Unit 1027, UMR 1027, INSERM, University of Toulouse III, Toulouse, France
| | - Yves Matillon
- Department of Pathways to Systemic Health-P2S-EA 4129, University Claude Bernard Lyon I, Lyon, France
| | - Virginie Ehlinger
- Research Unit 1027, UMR 1027, INSERM, University of Toulouse III, Toulouse, France
| | - Christophe Vayssiere
- Department of Obstetrics and Gynaecology, Toulouse University Hospital, Toulouse, France.,Research Unit 1027, UMR 1027, INSERM, University of Toulouse III, Toulouse, France
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Amer-Wåhlin I, Ugwumadu A, Yli BM, Kwee A, Timonen S, Cole V, Ayres-de-Campos D, Roth GE, Schwarz C, Ramenghi LA, Todros T, Ehlinger V, Vayssiere C. Fetal electrocardiography ST-segment analysis for intrapartum monitoring: a critical appraisal of conflicting evidence and a way forward. Am J Obstet Gynecol 2019; 221:577-601.e11. [PMID: 30980794 DOI: 10.1016/j.ajog.2019.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND In the past century, some areas of obstetric including intrapartum care have been slow to benefit from the dramatic advances in technology and medical care. Although fetal heart rate monitoring (cardiotocography) became available a half century ago, its interpretation often differs between institutions and countries, its diagnostic accuracy needs improvement, and a technology to help reduce the unnecessary obstetric interventions that have accompanied the cardiotocography is urgently needed. STUDY DESIGN During the second half of the 20th century, key findings in animal experiments captured the close relationship between myocardial glycogenolysis, myocardial workload, and ST changes, thus demonstrating that ST waveform analysis of the fetal electrocardiogram can provide information on oxygenation of the fetal myocardium and establishing the physiological basis for the use of electrocardiogram in intrapartum fetal surveillance. RESULTS Six randomized controlled trials, 10 meta-analyses, and more than 20 observational studies have evaluated the technology developed based on this principle. Nonetheless, despite this intensive assessment, differences in study protocols, inclusion criteria, enrollment rates, clinical guidelines, use of fetal blood sampling, and definitions of key outcome parameters, as well as inconsistencies in randomized controlled trial data handling and statistical methodology, have made this voluminous evidence difficult to interpret. Enormous resources spent on randomized controlled trials have failed to guarantee the generalizability of their results to other settings or their ability to reflect everyday clinical practice. CONCLUSION The latest meta-analysis used revised data from primary randomized controlled trials and data from the largest randomized controlled trials from the United States to demonstrate a significant reduction of metabolic acidosis rates by 36% (odds ratio, 0.64; 95% confidence interval, 0.46-0.88) and operative vaginal delivery rates by 8% (relative risk, 0.92; 95% confidence interval, 0.86-0.99), compared with cardiotocography alone.
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Abstract
Abstract
Problem
For two decades, France has taken part in two “competing” school-based, cross-national surveys exploring the health behaviors and well-being of adolescent (Health Behavior in School-aged Children (HBSC) survey, 11-13-15 year-olds) and their substance use (European School Project on Alcohol and other Drugs (ESPAD), 15-16 year-olds).
Description of problem
Since 2010, French data is provided at national level by grade rather than age. This allowed providing a continuous observation of health behaviors among adolescents, looking at the temporal spread of substance use and providing a better understanding of the role of school as a setting for adolescents’ health. But the difficulty of participating every 4 years in two big surveys remained.
Effects of changes
In 2018, France decided to conduct the 2 surveys in a unified and simultaneous way across middle- and high-school. This project is called ’National Survey in Middle- and High-school for Adolescents on Health and Substances’, EnCLASS, explicit acronym easy to pronounce and remember in French. If the main objective of “merging” these surveys is to improve the monitoring of health behaviours and substance use throughout adolescence, it also allows a significant gain regarding preparation, coordination and organization of the fieldwork, hence of overall costs, while ensuring perfect comparability of data at international level.
Evolution of data visualization on substance use will be used to illustrate the challenges and improvements of such a process, based on data collected in 2018 among more than 20,000 representative secondary-school students.
Lessons
In addition to a greater facility of interpreting and reading findings, presenting data throughout secondary school grades improves its impact and use in a public health perspective and allowing identifying operational targets for prevention and health promotion in schools, as classes are their main settings.
Key messages
EnCLASS is unique in Europe, it ensures an excellent comparability of data at international level while providing an innovative national monitoring of adolescent health behavior, including drug use. Further, by its improved quality, perspective and relevance, EnCLASS can contribute to Public health policies analysis regarding school-students in France in a less expensive and better way.
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Affiliation(s)
- E Godeau
- EHESP, Rennes Cedex, France
- UMR 1027, INSERM-Université Toulouse III, Toulouse, France
| | - V Ehlinger
- UMR 1027, INSERM-Université Toulouse III, Toulouse, France
| | - S Spilka
- OFDT, Paris, France
- CESP, Faculté de Médecine, Université Paris Sud, Faculté de Médecine UVSQ, INSERM, Université Paris-Saclay, Villejuif Paris, France
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Pacoricona Alfaro DL, Lemoine P, Ehlinger V, Molinas C, Diene G, Valette M, Pinto G, Coupaye M, Poitou-Bernert C, Thuilleaux D, Arnaud C, Tauber M. Causes of death in Prader-Willi syndrome: lessons from 11 years' experience of a national reference center. Orphanet J Rare Dis 2019; 14:238. [PMID: 31684997 PMCID: PMC6829836 DOI: 10.1186/s13023-019-1214-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/24/2019] [Indexed: 12/12/2022] Open
Abstract
Background In the last 20 years, substantial improvements have been made in the diagnosis, treatment and management of patients with Prader-Willi syndrome (PWS). Few data on causes of death are available since those improvements were made. Our study assessed the causes of death among French patients with PWS over the first 11 years of experience of the nationwide French Reference Center for PWS (FRC-PWS). Methods Our study relied on two sources of mortality information at national level between 2004 and 2014: The French Epidemiological Centre for the Medical Causes of Death (CépiDc) Registry and the FRC-PWS database. Causes of death were classified into seven categories: respiratory, cardiovascular, gastrointestinal, severe infection, sudden death, other causes, and unknown. Descriptive statistics were calculated separately for children (< 18 years-old) and adults (≥18 years-old). Results One hundred and four deaths were identified in France from 2004 to 2014. The median age at death was 30 years, ranging from less than 1 month to 58 years. Seventeen deaths occurred in patients under 18 years, with 70% of them in children under 2 years. Respiratory causes accounted for more than 50% of the deaths in patients with PWS in both children and adults. Both cause and age of death did not significantly differ according to gender or genetic subtype. Conclusions Patients with PWS die prematurely due to a respiratory cause in most cases at all ages. In those adult patients with data on obesity, 98% were reported to be obese.
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Affiliation(s)
| | - Perrine Lemoine
- Endocrinology, Obesity, Bone Diseases, Genetics and Gynecology Unit, Children's Hospital, University Hospital Center of Toulouse, Toulouse, France
| | | | - Catherine Molinas
- Endocrinology, Obesity, Bone Diseases, Genetics and Gynecology Unit, Children's Hospital, University Hospital Center of Toulouse, Toulouse, France.,French National Reference Center for Prader-Willi Syndrome, Children's Hospital, University Hospital Center of Toulouse, 330, avenue de Grande-Bretagne - TSA 40031, 31059, Toulouse cedex 9, France.,Centre de Physiopathologie de Toulouse-Purpan, UMR 5282 CNRS, UMR 1043 Inserm, Paul Sabatier University, Toulouse, France
| | - Gwénaëlle Diene
- UMR 1027 Inserm- Paul Sabatier University, Toulouse, France.,Endocrinology, Obesity, Bone Diseases, Genetics and Gynecology Unit, Children's Hospital, University Hospital Center of Toulouse, Toulouse, France.,French National Reference Center for Prader-Willi Syndrome, Children's Hospital, University Hospital Center of Toulouse, 330, avenue de Grande-Bretagne - TSA 40031, 31059, Toulouse cedex 9, France
| | - Marion Valette
- Endocrinology, Obesity, Bone Diseases, Genetics and Gynecology Unit, Children's Hospital, University Hospital Center of Toulouse, Toulouse, France.,French National Reference Center for Prader-Willi Syndrome, Children's Hospital, University Hospital Center of Toulouse, 330, avenue de Grande-Bretagne - TSA 40031, 31059, Toulouse cedex 9, France
| | - Graziella Pinto
- Pediatric Endocrinology, Diabetology and Gynecology Department, Assistance-Publique Hôpitaux de Paris (AP-HP), Necker Children's University Hospital, Paris, France
| | - Muriel Coupaye
- French National Reference Center for Prader-Willi Syndrome, Nutrition Department, Assistance-Publique Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Paris, France
| | - Christine Poitou-Bernert
- French National Reference Center for Prader-Willi Syndrome, Nutrition Department, Assistance-Publique Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Paris, France.,Nutriomics team, Sorbonne University, UPMC University Paris 06, Inserm, Paris, France
| | - Denise Thuilleaux
- French National Reference Center for Prader-Willi Syndrome, Prader-Willi Unit, Assistance Publique Hôpitaux de Paris (AP-HP), Marine Hendaye Hospital, Hendaye, France
| | - Catherine Arnaud
- UMR 1027 Inserm- Paul Sabatier University, Toulouse, France.,Unité de Soutien Méthodologique à la Recherche, University Hospital Center of Toulouse, Toulouse, France
| | - Maithé Tauber
- Endocrinology, Obesity, Bone Diseases, Genetics and Gynecology Unit, Children's Hospital, University Hospital Center of Toulouse, Toulouse, France. .,French National Reference Center for Prader-Willi Syndrome, Children's Hospital, University Hospital Center of Toulouse, 330, avenue de Grande-Bretagne - TSA 40031, 31059, Toulouse cedex 9, France. .,Centre de Physiopathologie de Toulouse-Purpan, UMR 5282 CNRS, UMR 1043 Inserm, Paul Sabatier University, Toulouse, France.
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26
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Fernandez de Grado G, Ehlinger V, Godeau E, Sentenac M, Arnaud C, Nabet C, Monsarrat P. Socioeconomic and behavioral determinants of tooth brushing frequency: results from the representative French 2010 HBSC cross-sectional study. J Public Health Dent 2018; 78:221-230. [DOI: 10.1111/jphd.12265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 11/17/2017] [Accepted: 12/08/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Gabriel Fernandez de Grado
- Department of Epidemiology and Public Health; Paul Sabatier University, Toulouse University Hospital; Toulouse France
- UMR 1027 INSERM, Paul Sabatier University; Toulouse France
- UMR 1260 INSERM, University of Strasbourg, Regenerative Nanomedicine; Strasbourg France
| | | | - Emmanuelle Godeau
- UMR 1027 INSERM, Paul Sabatier University; Toulouse France
- Service Médical du Rectorat de Toulouse (Ministry of Education); Toulouse France
| | | | | | - Cathy Nabet
- Department of Epidemiology and Public Health; Paul Sabatier University, Toulouse University Hospital; Toulouse France
- UMR 1027 INSERM, Paul Sabatier University; Toulouse France
| | - Paul Monsarrat
- Department of Anatomical Sciences and Radiology; Paul Sabatier University, Toulouse University Hospital; Toulouse France
- STROMALab, Université de Toulouse, CNRS ERL 5311, EFS, INP-ENVT, INSERM, UPS; Toulouse France
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27
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Vayssiere C, Gaudineau A, Gallini A, Rozenberg P, Morin M, Roth E, Orusco E, Javoise S, Fort J, Lavergne C, Ehlinger V, Senat MV, Arnaud C. 93: Induction of labor at term with a live fetus: is 25μg of vaginal misoprostol non inferior to slow release 10mg PGE2 Pessary? CYTOPRO, A french multicentre randomized controlled trial, (NCT01765881). Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.10.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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28
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Palas D, Ehlinger V, Alberge C, Truffert P, Kayem G, Goffinet F, Ancel PY, Arnaud C, Vayssière C. Efficacy of antenatal corticosteroids in preterm twins: the EPIPAGE-2 cohort study. BJOG 2017; 125:1164-1170. [PMID: 29119673 DOI: 10.1111/1471-0528.15014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the efficacy of antenatal corticosteroid (ACS) therapy on short-term neonatal outcomes in preterm twins, and further document the influence of the ACS-to-delivery interval. DESIGN EPIPAGE-2 is a nationwide observational multicentre prospective cohort study of neonates born between 22 and 34 completed weeks of gestation. SETTING All French maternity units, except in a single administrative region, between March and December 2011. POPULATION A total of 750 twin neonates born between 24 and 31 weeks of gestation. METHODS Exposure to ACSs was examined in four groups: single complete course, with an ACS administration-to-delivery interval of ≤7 days; single complete course, with an ACS-to-delivery interval of >7 days; repeated courses; or no ACS treatment. MAIN OUTCOME MEASURES Neonatal outcomes analysed were severe bronchopulmonary dysplasia, periventricular leukomalacia or intraventricular haemorrhage grade III/IV, in-hospital mortality, and a composite indicator of severe outcomes. RESULTS Compared with no ACSs, in multivariable analysis, a single course of ACSs with an administration-to-delivery interval of ≤7 days was significantly associated with a reduced rate of periventricular leukomalacia or intraventricular haemorrhage grade III/IV (aOR 0.2; CI 95% 0.1-0.5), in-hospital mortality (0.3; 0.1-0.6), and the composite indicator (0.1; 0.1-0.3), whereas a single course of ACDs with an administration-to-delivery interval of >7 days did not significantly reduce the frequency of in-hospital mortality (0.7; 0.3-1.8). No significant differences in terms of benefit or risk were found when comparing repeated courses with a single complete course. CONCLUSION In preterm twins, a single complete course of antenatal corticosteroids was associated with an improvement of severe neurological outcome, whereas reduced in-hospital mortality was seen only when the ACS-to-delivery interval was ≤7 days. TWEETABLE ABSTRACT A single complete course of antenatal steroids reduced severe neurological morbidity in preterm twins (24-31 weeks).
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Affiliation(s)
- D Palas
- IMR 1027 INSERM, Team SPHERE, Toulouse III University, Toulouse, France.,Department of Medical Information, Albi Hospital, Albi, France
| | - V Ehlinger
- IMR 1027 INSERM, Team SPHERE, Toulouse III University, Toulouse, France.,Neonatal Intensive Care Unit, CHU Toulouse, Toulouse University, Toulouse, France
| | - C Alberge
- IMR 1027 INSERM, Team SPHERE, Toulouse III University, Toulouse, France.,Neonatal Intensive Care Unit, CHU Toulouse, Toulouse University, Toulouse, France
| | - P Truffert
- Department of Neonatal Intensive Care Unit, Jeanne de Flandre Hospital, CHRU Lille, Lille, France
| | - G Kayem
- Department of Obstetrics and Gynaecology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie University, Paris, France.,UMR 1053 INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Paris, France
| | - F Goffinet
- UMR 1053 INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Paris, France.,Port-Royal Maternity, CHU Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - P-Y Ancel
- UMR 1053 INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Paris, France.,Clinical Research Unit, Center for Clinical Investigation P1419, CHU Cochin Broca Hôtel-Dieu, Paris, France
| | - C Arnaud
- IMR 1027 INSERM, Team SPHERE, Toulouse III University, Toulouse, France.,Clinical Epidemiology Unit, Toulouse III University, Toulouse, France
| | - C Vayssière
- IMR 1027 INSERM, Team SPHERE, Toulouse III University, Toulouse, France.,Department of Obstetrics and Gynaecology, Paule de Viguier Hospital, CHU Toulouse, Toulouse, France
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29
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Cambonie G, Muller JB, Ehlinger V, Roy J, Guédeney A, Lebeaux C, Kaminski M, Alberge C, Denizot S, Ancel PY, Arnaud C. Mother-infant interaction assessment at discharge and at 6 months in a French cohort of infants born very preterm: The OLIMPE study. PLoS One 2017; 12:e0188942. [PMID: 29216238 PMCID: PMC5720768 DOI: 10.1371/journal.pone.0188942] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 11/15/2017] [Indexed: 01/18/2023] Open
Abstract
Objectives The principal aim was to investigate the feasibility of assessing mother-infant interactions at discharge and at 6 months infant corrected age in singletons born before 32 weeks of gestation. The secondary aims were to describe these interactions and their disorders, explore the association between maternal emotional state and the interactions, and assess the relationship between disordered interactions and infant social withdrawal behaviour. Methods OLIMPE is an ancillary study of the population-based study EPIPAGE 2, which recruited preterm neonates in France in 2011. 163 dyads participated at discharge and 148 at 6 months. Interactions were observed with the Attachment During Stress (ADS) scale, which includes two behavioural subscales, for the mother (m-ADS) and her infant (i-ADS). Two professionals independently completed the ADS scales for one third of the observations. Maternal emotional state was assessed using self-administered questionnaires of depression, anxiety, and stress. Infant’s social withdrawal behaviour at 6 months was measured by the Alarm Distress Baby scale. Results At discharge, 15.3% of the m-ADS scales and 43.3% of the i-ADS scales had at least one unobserved component. At 6 months, all items on both scales were noticeable in >90% of the dyads. Reliability, estimated by the kappa coefficient, ranged between 0.39 and 0.76 at discharge, and between 0.21 and 0.69 at 6 months. Disordered interactions were indicated on 48.6% of the m-ADS scales and 36.5% of the i-ADS scales at discharge. At 6 months, these rates were 32.6% and 26.0%. Disordered interactions at 6 months were associated with identified disorder at discharge. Insecure infant attachment was not influenced by maternal mental health but was strongly associated with infant social withdrawal behaviour. Conclusions The ADS scale can be used to screen for early interaction disorders after premature birth and may help to target dyads that would most benefit from early intervention.
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Affiliation(s)
- Gilles Cambonie
- Department of Neonatal Medicine, Arnaud de Villeneuve University Hospital, Montpellier, France
- * E-mail:
| | - Jean-Baptiste Muller
- Department of Neonatal Medicine, Women’s and Children’s University Hospital, Nantes, France
| | - Virginie Ehlinger
- UMR 1027 INSERM, University Paul Sabatier Toulouse III, Toulouse, France
| | - Joël Roy
- Child and Adolescent Psychiatry Unit, Nîmes University Hospital, Nîmes, France
| | - Antoine Guédeney
- Child and Adolescent Psychiatry Unit, Bichat-Claude Bernard University Hospital, Paris, France
| | - Cécile Lebeaux
- Inserm UMR 1153 Obstetrical, Perinatal and Paediatric Epidemiology Research Team (Epopé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Monique Kaminski
- Inserm UMR 1153 Obstetrical, Perinatal and Paediatric Epidemiology Research Team (Epopé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Corine Alberge
- Department of Neonatal Medicine, Children's University Hospital, Toulouse, France
| | - Sophie Denizot
- Department of Neonatal Medicine, Women’s and Children’s University Hospital, Nantes, France
| | - Pierre-Yves Ancel
- Inserm UMR 1153 Obstetrical, Perinatal and Paediatric Epidemiology Research Team (Epopé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Catherine Arnaud
- UMR 1027 INSERM, University Paul Sabatier Toulouse III, Toulouse, France
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Sentenac M, Ehlinger V, Napoletano A, Spilka S, Gariepy G, Godeau E, Elgar FJ. Relative deprivation and episodes of drunkenness among French and Canadian adolescents. Drug Alcohol Rev 2017; 36:788-796. [PMID: 28470930 DOI: 10.1111/dar.12540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 01/31/2017] [Accepted: 02/04/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Studies link socio-economic deprivation to alcohol consumption in adolescents, but the role of relative deprivation has been understudied and may be equally important. This study investigates the association between relative deprivation and episodes of drunkenness among adolescents in France and Canada. DESIGN AND METHODS We used data from the 2014 Health Behaviours in School-aged Children study collected from 15-year-olds in Canada (n = 4276) and France (n = 1625). Students reported the number of times they had ever been drunk. The degree of relative deprivation was quantified through the student's rank in the deprivation distribution, measured through the Family Affluence Scale, within school and the extent of the inequality. Random intercept logistic regression models were used to examine the association between relative deprivation and drunkenness. RESULTS Canadian adolescents were more likely to have experienced drunkenness more than once in their lifetime compared with French adolescents (21.6% vs. 16.2%). Adolescents with high relative deprivation were not more likely to report episodes of drunkenness in Canada and were less likely to report episodes of drunkenness in France compared with those with low relative deprivation. DISCUSSION AND CONCLUSIONS Our findings do not support the hypothesis that adolescents who experienced greater relative deprivation are more likely to report drunkenness. They suggest that policies and interventions on alcohol use should target adolescents across all levels of deprivation in Canada and particularly those that are relatively more affluent in France. The context of countries appears to matter to the socio-economic distribution of drinking behaviour in youth. [Sentenac M, Ehlinger V, Napoletano A, Spilka S, Gariepy G, Godeau E, Elgar FJ. Relative deprivation and episodes of drunkenness among French and Canadian adolescents.
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Affiliation(s)
- Mariane Sentenac
- Institute for Health and Social Policy, McGill University, Montreal, Canada.,French National Institute of Health and Medical Research, UMR 1027, Paul Sabatier University, Toulouse, France
| | - Virginie Ehlinger
- French National Institute of Health and Medical Research, UMR 1027, Paul Sabatier University, Toulouse, France
| | - Anthony Napoletano
- Institute for Health and Social Policy, McGill University, Montreal, Canada
| | - Stanislas Spilka
- Observatoire Francais des Drogues et des Toxicomanies, Saint Denis, France.,French National Institute of Health and Medical Research U1178, Paris, France
| | - Geneviève Gariepy
- Institute for Health and Social Policy, McGill University, Montreal, Canada
| | - Emmanuelle Godeau
- French National Institute of Health and Medical Research, UMR 1027, Paul Sabatier University, Toulouse, France.,Service Médical du Rectorat, Toulouse, France
| | - Frank J Elgar
- Institute for Health and Social Policy, McGill University, Montreal, Canada.,Douglas Mental Health University Institute, Montreal, Canada
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Dicky O, Ehlinger V, Montjaux N, Gremmo-Féger G, Sizun J, Rozé JC, Arnaud C, Casper C. Policy of feeding very preterm infants with their mother's own fresh expressed milk was associated with a reduced risk of bronchopulmonary dysplasia. Acta Paediatr 2017; 106:755-762. [PMID: 28128874 DOI: 10.1111/apa.13757] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/17/2016] [Accepted: 01/23/2017] [Indexed: 01/30/2023]
Abstract
AIM Since 2005, the French Food Safety Agency has recommended that very preterm or low-birthweight babies should be fed with pasteurised, expressed breastmilk, and feeding policies on this vary widely in French neonatal units. We investigated the differences between using a mother's expressed milk, in fresh or pasteurised forms, for very preterm infants. METHODS This observational multicentre study analysed data on 926 very preterm infants: 636 from neonatal units who used the mother's own fresh milk and 290 who used the mother's milk after pasteurisation. We analysed necrotising enterocolitis, bronchopulmonary dysplasia, in-hospital mortality, late-onset sepsis, weight gain, length of hospital stay, the duration of parenteral nutrition and the duration of enteral feeding with a nasogastric tube. Multivariate analyses were conducted to assess the impact of maternal milk policies. RESULTS After adjustment, there was a reduced risk of bronchopulmonary dysplasia in the fresh milk group with an odds ratio of 0.40 and 95% confidence interval of 0.27-0.67 (p < 0.001). No other statistically significant differences were observed. CONCLUSION Feeding very preterm infants with their mother's expressed fresh milk was associated with a reduced risk of bronchopulmonary dysplasia, and further investigations are needed to evaluate the clinical impact of this practice.
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Affiliation(s)
- Odile Dicky
- Department of Neonatology; Children Hospital; University Hospital; Toulouse France
- U.1027; INSERM; Toulouse France
- Paul Sabatier University; Toulouse France
| | - Virginie Ehlinger
- U.1027; INSERM; Toulouse France
- Paul Sabatier University; Toulouse France
| | - Nathalie Montjaux
- Department of Neonatology; Children Hospital; University Hospital; Toulouse France
| | | | - Jacques Sizun
- Department of Woman, Mother and Child; University Hospital; Brest France
| | | | - Catherine Arnaud
- U.1027; INSERM; Toulouse France
- Paul Sabatier University; Toulouse France
- Clinical Epidemiology Unit; CHU Purpan; Toulouse France
| | - Charlotte Casper
- Department of Neonatology; Children Hospital; University Hospital; Toulouse France
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32
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Pacoricona Alfaro DL, Ehlinger V, Spilka S, Ross J, Sentenac M, Godeau E. Alcohol, tobacco and cannabis use: Do students with mild-intellectual disability mimic students in the general population? Res Dev Disabil 2017; 63:118-131. [PMID: 27793551 DOI: 10.1016/j.ridd.2016.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 10/18/2016] [Accepted: 10/18/2016] [Indexed: 06/06/2023]
Abstract
Education policies encourage inclusion of students with mild-intellectual disability (mild-ID) in community/school life. However, such policies potentially increase exposure to substance use. This article examines tobacco, alcohol and cannabis use among French students enrolled in special units for students with disabilities (ULIS) at mainstream junior high schools compared to those of general population of the equivalent age; and explores factors associated with substance use among ULIS students, known to present mostly mild-ID. In 2014, a questionnaire adapted from the international HBSC/WHO study was administered to 700 ULIS students (mean-age 14.2). Comparative data were gathered from 7023 junior high-school students (mean-age 13.6) in the general population. Among students <14 years-old, tobacco and alcohol use rates were similar between ULIS and general population. For students ≥14, alcohol use remained comparable, while tobacco and cannabis use were higher in general population. Among ULIS students, low perceived health/life satisfaction, divorced/separated parents and high perceived academic demands were associated with tobacco use. Bullying, not liking school very much and attending schools outside a deprived area were associated with alcohol use. Having had sexual intercourse and not perceiving one's health as excellent were associated with cannabis use. Having dated was associated with using all three substances.
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Affiliation(s)
| | | | - Stanislas Spilka
- Observatoire Français des Drogues et des Toxicomanies (OFDT), Saint Denis, France; Inserm U1178, Paris, France
| | - Jim Ross
- Association pour le développement d'HBSC, Toulouse, France
| | - Mariane Sentenac
- Inserm UMR1027-Université Paul Sabatier, Toulouse, France; Institute for Health and Social Policy, McGill University, Montreal, Canada
| | - Emmanuelle Godeau
- Inserm UMR1027-Université Paul Sabatier, Toulouse, France; Association pour le développement d'HBSC, Toulouse, France; Service médical du rectorat de Toulouse, France.
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Rapp M, Eisemann N, Arnaud C, Ehlinger V, Fauconnier J, Marcelli M, Michelsen SI, Nystrand M, Colver A, Thyen U. Predictors of parent-reported quality of life of adolescents with cerebral palsy: A longitudinal study. Res Dev Disabil 2017; 62:259-270. [PMID: 28110883 DOI: 10.1016/j.ridd.2016.12.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 12/14/2016] [Accepted: 12/18/2016] [Indexed: 06/06/2023]
Abstract
AIM Parent-reporting is needed to examine Quality of Life (QoL) of children with cerebral palsy (CP) across all severities. This study examines whether QoL changes between childhood and adolescence, and what predicts adolescent QoL. METHOD SPARCLE is a European cohort study of children with CP, randomly sampled from population databases. Of 818 8-12-year-olds joining the study, 594 (73%) were revisited as 13-17-year-olds. The subject of this report is the 551 (316 boys, 235 girls) where the same parent reported QoL on both occasions using KIDSCREEN-52 (transformed Rasch scale, mean 50, SD 10 per domain). Associations were assessed using linear regression. RESULTS Between childhood and adolescence, average QoL reduced in six domains (1.3-3.8 points, p<0.01) and was stable in three (Physical wellbeing, Autonomy, Social acceptance). Socio-demographic factors had little predictive value. Childhood QoL was a strong predictor of all domains of adolescent QoL. Severe impairments of motor function, IQ or communication predicted higher adolescent QoL on some domains; except that severe motor impairment predicted lower adolescent QoL on the Autonomy domain. More psychological problems and higher parenting stress in childhood and their worsening by adolescence predicted lower QoL in five and eight domains respectively; contemporaneous pain in seven domains. The final model explained 30%-40% of variance in QoL, depending on domain. INTERPRETATION In general, impairment severity and socio-demographic factors were not predictors of lower adolescent QoL. However, pain, psychological problems and parenting stress were predictors of lower adolescent QoL in most domains. These are modifiable factors and addressing them may improve adolescent QoL.
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Affiliation(s)
- Marion Rapp
- Department of Pediatrics, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
| | - Nora Eisemann
- Institute of Cancer Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
| | - Catherine Arnaud
- INSERM, UMR 1027, Paul Sabatier University, Purpan, Clinical Epidemiology Unit, Toulouse, France.
| | | | - Jérôme Fauconnier
- UJF-Grenoble 1/CNRS/CHU de Grenoble/TIMC-IMAG UMR 5525/Themas, Grenoble F-38041, France.
| | | | - Susan I Michelsen
- National Institute of Public Health, University of Southern Denmark, Oster Farimagsgade 5, 1353 Copenhagen, Denmark.
| | - Malin Nystrand
- Gothenburg University, The Queen Silvia Children's Hospital, S-41685 Gothenburg, Sweden.
| | - Allan Colver
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
| | - Ute Thyen
- Department of Pediatrics, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
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Tauber M, Boulanouar K, Diene G, Çabal-Berthoumieu S, Ehlinger V, Fichaux-Bourin P, Molinas C, Faye S, Valette M, Pourrinet J, Cessans C, Viaux-Sauvelon S, Bascoul C, Guedeney A, Delhanty P, Geenen V, Martens H, Muscatelli F, Cohen D, Consoli A, Payoux P, Arnaud C, Salles JP. The Use of Oxytocin to Improve Feeding and Social Skills in Infants With Prader-Willi Syndrome. Pediatrics 2017; 139:peds.2016-2976. [PMID: 28100688 DOI: 10.1542/peds.2016-2976] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Patients with Prader-Willi syndrome (PWS) display poor feeding and social skills as infants and fewer hypothalamic oxytocin (OXT)-producing neurons were documented in adults. Animal data demonstrated that early treatment with OXT restores sucking after birth. Our aim is to reproduce these data in infants with PWS. METHODS We conducted a phase 2 escalating dose study of a short course (7 days) of intranasal OXT administration. We enrolled 18 infants with PWS under 6 months old (6 infants in each step) who received 4 IU of OXT either every other day, daily, or twice daily. We investigated the tolerance and the effects on feeding and social skills and changes in circulating ghrelin and brain connectivity by functional MRI. RESULTS No adverse events were reported. No dose effect was observed. Sucking assessed by the Neonatal Oral-Motor Scale was abnormal in all infants at baseline and normalized in 88% after treatment. The scores of Neonatal Oral-Motor Scale and videofluoroscopy of swallowing significantly decreased from 16 to 9 (P < .001) and from 18 to 12.5 (P < .001), respectively. Significant improvements in Clinical Global Impression scale scores, social withdrawal behavior, and mother-infant interactions were observed. We documented a significant increase in acylated ghrelin and connectivity of the right superior orbitofrontal network that correlated with changes in sucking and behavior. CONCLUSIONS OXT is well tolerated in infants with PWS and improves feeding and social skills. These results open perspectives for early treatment in neurodevelopment diseases with feeding problems.
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Affiliation(s)
- Maïthé Tauber
- Unité d'Endocrinologie, Obésité, Maladies Osseuses, Génétique et Gynécologie Médicale. Centre de Référence du Syndrome de Prader-Willi, .,Axe Pédiatrique du Centre d'Investigation Clinique 9302/Intitut National de la Santé Et de la Recherche Médicale, and.,Institut National de la Santé Et de la Recherche Médicale Unité 1043, Centre de Physiopathologie de Toulouse Purpan, Université Paul Sabatier, Toulouse, France
| | - Kader Boulanouar
- Toulouse NeuroImaging Center, Université de Toulouse, Institut National de la Santé Et de la Recherche Médicale, Université Paul Sabatier, Toulouse, France
| | - Gwenaelle Diene
- Unité d'Endocrinologie, Obésité, Maladies Osseuses, Génétique et Gynécologie Médicale. Centre de Référence du Syndrome de Prader-Willi.,Institut National de la Santé Et de la Recherche Médicale, Unité Mixte de Recherche 1027, Université Toulouse III, Hôpital Paule de Viguier, Toulouse, France
| | - Sophie Çabal-Berthoumieu
- Unité d'Endocrinologie, Obésité, Maladies Osseuses, Génétique et Gynécologie Médicale. Centre de Référence du Syndrome de Prader-Willi.,Service de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital des Enfants, Toulouse, France
| | - Virginie Ehlinger
- Institut National de la Santé Et de la Recherche Médicale, Unité Mixte de Recherche 1027, Université Toulouse III, Hôpital Paule de Viguier, Toulouse, France
| | - Pascale Fichaux-Bourin
- Unité d'Endocrinologie, Obésité, Maladies Osseuses, Génétique et Gynécologie Médicale. Centre de Référence du Syndrome de Prader-Willi
| | - Catherine Molinas
- Unité d'Endocrinologie, Obésité, Maladies Osseuses, Génétique et Gynécologie Médicale. Centre de Référence du Syndrome de Prader-Willi.,Axe Pédiatrique du Centre d'Investigation Clinique 9302/Intitut National de la Santé Et de la Recherche Médicale, and.,Institut National de la Santé Et de la Recherche Médicale Unité 1043, Centre de Physiopathologie de Toulouse Purpan, Université Paul Sabatier, Toulouse, France
| | - Sandy Faye
- Unité d'Endocrinologie, Obésité, Maladies Osseuses, Génétique et Gynécologie Médicale. Centre de Référence du Syndrome de Prader-Willi.,Axe Pédiatrique du Centre d'Investigation Clinique 9302/Intitut National de la Santé Et de la Recherche Médicale, and
| | - Marion Valette
- Unité d'Endocrinologie, Obésité, Maladies Osseuses, Génétique et Gynécologie Médicale. Centre de Référence du Syndrome de Prader-Willi.,Axe Pédiatrique du Centre d'Investigation Clinique 9302/Intitut National de la Santé Et de la Recherche Médicale, and
| | - Jeanne Pourrinet
- Unité d'Endocrinologie, Obésité, Maladies Osseuses, Génétique et Gynécologie Médicale. Centre de Référence du Syndrome de Prader-Willi
| | - Catie Cessans
- Unité d'Endocrinologie, Obésité, Maladies Osseuses, Génétique et Gynécologie Médicale. Centre de Référence du Syndrome de Prader-Willi
| | - Sylvie Viaux-Sauvelon
- Service de Psychiatrie de l'Enfant et de l'Adolescent, la Pitié Salpêtrière, Paris, France
| | - Céline Bascoul
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital des Enfants, Toulouse, France
| | - Antoine Guedeney
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital Bichat-Claude Bernard, Paris, France
| | - Patric Delhanty
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Vincent Geenen
- Grappe Interdisciplinaire de Génoprotéomique Appliquée-I3-Immunoendocrinologie, Université de Liège, Sart Tilman, Liege, Belgium
| | - Henri Martens
- Grappe Interdisciplinaire de Génoprotéomique Appliquée-I3-Immunoendocrinologie, Université de Liège, Sart Tilman, Liege, Belgium
| | - Françoise Muscatelli
- Institut de Neurobiologie de la Méditerranée, Institut de la Santé Et de la Recherche Médicale Unité 901, Marseille, France
| | - David Cohen
- Service de Psychiatrie de l'Enfant et de l'Adolescent, la Pitié Salpêtrière, Paris, France.,Centre National de la Recherche Sscientifique, Unité Mixte de Recherche 7222, Institut des Systèmes Intelligents et de Robotiques, and
| | - Angèle Consoli
- Service de Psychiatrie de l'Enfant et de l'Adolescent, la Pitié Salpêtrière, Paris, France.,Groupe de Recherches Cliniques Abord dimensionnel des épisodes psychotiques de l'enfant et de l'adolescent, Université Pierre et Marie Curie, Paris France; and
| | - Pierre Payoux
- Toulouse NeuroImaging Center, Université de Toulouse, Institut National de la Santé Et de la Recherche Médicale, Université Paul Sabatier, Toulouse, France
| | - Catherine Arnaud
- Institut National de la Santé Et de la Recherche Médicale, Unité Mixte de Recherche 1027, Université Toulouse III, Hôpital Paule de Viguier, Toulouse, France.,Unité de Soutien méthodologique à la recherche, CHU Toulouse, Toulouse, France
| | - Jean-Pierre Salles
- Unité d'Endocrinologie, Obésité, Maladies Osseuses, Génétique et Gynécologie Médicale. Centre de Référence du Syndrome de Prader-Willi.,Axe Pédiatrique du Centre d'Investigation Clinique 9302/Intitut National de la Santé Et de la Recherche Médicale, and.,Institut National de la Santé Et de la Recherche Médicale Unité 1043, Centre de Physiopathologie de Toulouse Purpan, Université Paul Sabatier, Toulouse, France
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Liz Pacoricona Alfaro D, Ehlinger V, Spilka S, Ross J, Sentenac M, Godeau E. Expérimentation de substances psychoactives chez des élèves avec déficience cognitive scolarisés en unités localisées d’inclusion scolaire (ULIS). Therapie 2017. [DOI: 10.1016/j.therap.2016.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lemoine H, Ehlinger V, Groussolles M, Arnaud C, Vayssière C. [Does the paper speed in fetal heart monitoring during labour influence the variability in the interpretation by professionals?]. J Gynecol Obstet Hum Reprod 2016; 45:827-834. [PMID: 27496571 DOI: 10.1016/j.jgyn.2016.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 06/15/2016] [Accepted: 06/16/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Assessing inter- and intra- observer agreement in the reading of fetal heart rate (FHR) between two different paper speeds (1 and 2cm/min) using FIGO classification. MATERIAL AND METHODS Single-centre experimental study consisting in reading 60minutes FHR tracings by six readers (3 midwives and 3 obstetricians) during 1cm and 2cm/min sessions within a period of three weeks. The reading guideline was based on FIGO classification. Inter- and intra-observer agreement was assessed thanks to Kappa coefficient (K) and percentage of agreement (PA) using the classification of FHR tracings drawn up by readers. RESULTS Intra-observer agreement reached 60% between the two paper speeds, and PA ranged from 48 to 67%. Inter-observer agreement was poor to moderate (K=0.42 for 1cm/min sessions and K=0.38 for 2cm/min sessions). Inter-observer agreement was significantly higher for normal tracings (PA ranged from 55.2% for 2cm/min sessions to 57.4% for 1cm/min sessions). The preterminal category had the lowest concordance rates (PA=19% for 1cm/min sessions and 20, 7% for 2cm/min sessions). CONCLUSION This study did not highlight significant differences in intra- and inter-observer variability between the two FHR paper speeds. The 1cm/min paper speed, which is commonly used in France, is more economical and gives a better bedside overview of FHR. Therefore, it should be recommended.
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Affiliation(s)
- H Lemoine
- École de SF de Nancy, 10, rue du Dr-Heydenreich, CS 74213, 54042 Nancy cedex, France.
| | - V Ehlinger
- Inserm, unité UMR 1027, faculté de médecine, université Toulouse III, 37, allées J.-Guesde, 31062 Toulouse cedex 9, France
| | - M Groussolles
- Service de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue Grande-Bretagne, 31059 Toulouse cedex 9, France; Inserm, unité UMR 1027, faculté de médecine de Purpan, université Paul-Sabatier Toulouse III, 37, allées Jules-Guesde, 31073 Toulouse cedex, France
| | - C Arnaud
- Inserm, unité UMR 1027, faculté de médecine de Purpan, université Paul-Sabatier Toulouse III, 37, allées Jules-Guesde, 31073 Toulouse cedex, France; Unité de soutien méthodologique à la recherche, CHU de Toulouse, 31059 Toulouse, France
| | - C Vayssière
- Service de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue Grande-Bretagne, 31059 Toulouse cedex 9, France; Inserm, unité UMR 1027, faculté de médecine de Purpan, université Paul-Sabatier Toulouse III, 37, allées Jules-Guesde, 31073 Toulouse cedex, France
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Vayssière C, Ehlinger V, Paret L, Arnaud C. Is STAN monitoring associated with a significant decrease in metabolic acidosis at birth compared with cardiotocography alone? Review of the three meta-analyses that included the recent US trial. Acta Obstet Gynecol Scand 2016; 95:1190-1. [DOI: 10.1111/aogs.12923] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Christophe Vayssière
- Gynecology and Obstetrics Department; Paule de Viguier Hospital; CHU Toulouse; Toulouse France
- UMR 1027 INSERM; University Paul Sabatier Toulouse III; Toulouse France
| | - Virginie Ehlinger
- UMR 1027 INSERM; University Paul Sabatier Toulouse III; Toulouse France
| | - Louise Paret
- Gynecology and Obstetrics Department; Paule de Viguier Hospital; CHU Toulouse; Toulouse France
| | - Catherine Arnaud
- UMR 1027 INSERM; University Paul Sabatier Toulouse III; Toulouse France
- Clinical Epidemiology Unit; University Hospital; Toulouse France
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Cessans C, Ehlinger V, Arnaud C, Yart A, Capri Y, Barat P, Cammas B, Lacombe D, Coutant R, David A, Baron S, Weill J, Leheup B, Nicolino M, Salles JP, Verloes A, Tauber M, Cavé H, Edouard T. Growth patterns of patients with Noonan syndrome: correlation with age and genotype. Eur J Endocrinol 2016; 174:641-50. [PMID: 26903553 DOI: 10.1530/eje-15-0922] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 02/22/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Growth patterns of patients with Noonan syndrome (NS) were established before the involved genes were identified. OBJECTIVE The goal of this study was to compare growth parameters according to genotype in patients with NS. SUBJECTS AND METHODS The study population included 420 patients (176 females and 244 males) harboring mutations in the PTPN11, SOS1, RAF1, or KRAS genes. NS-associated PTPN11 mutations (NS-PTPN11) and NS with multiple lentigines-associated PTPN11 mutations (NSML-PTPN11) were distinguished. Birth measures and height and body mass index (BMI) measures at 2, 5, 10 years, and adulthood were compared with the general population and between genotypes. RESULTS Patients with NS were shorter at birth (mean birth length standard deviation score (SDS): -1.0 ± 1.4; P < 0.001) and throughout childhood than the healthy population, with height SDS being -2.1 ± 1.3 at 2 years, and -2.1 ± 1.2 at 5 and 10 years and adulthood (P < 0.001). At birth, patients with NS-PTPN11 were significantly shorter and thinner than patients with NSML-PTPN11, SOS1, or KRAS. Growth retardation was significantly less severe and less frequent at 2 years in patients with NSML-PTPN11 and SOS1 than in patients with NS-PTPN11 (P < 0.001 and P = 0.002 respectively). Patients with NS had lower BMI at 10 years (P < 0.001). No difference between genotypes was demonstrated. CONCLUSION Determining the growth patterns of patients with NS according to genotype should better inform clinicians about the natural course of growth in NS so that they can optimize the follow-up and management of these patients.
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Affiliation(s)
- Catie Cessans
- EndocrineBone Diseases, and Genetics Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Virginie Ehlinger
- UMR 1027 INSERMUniversity of Toulouse Paul Sabatier, Toulouse, France
| | - Catherine Arnaud
- UMR 1027 INSERMUniversity of Toulouse Paul Sabatier, Toulouse, France Clinical Epidemiology UnitToulouse University Hospital, Toulouse, France
| | - Armelle Yart
- INSERM UMR 1048Institute of Cardiovascular and Metabolic Diseases (I2MC), University of Toulouse Paul Sabatier, Toulouse, France
| | - Yline Capri
- Departments of GeneticsRobert-Debré University Hospital, APHP, Paris, France
| | - Pascal Barat
- Pediatric Endocrinology DepartmentClinical investigation Centre (CIC 1401), Bordeaux University Hospital, Bordeaux, France
| | - Benoit Cammas
- Pediatric Endocrinology DepartmentClinical investigation Centre (CIC 1401), Bordeaux University Hospital, Bordeaux, France
| | - Didier Lacombe
- Genetics DepartmentBordeaux University Hospital, EA4576, Bordeaux, France
| | - Régis Coutant
- Pediatric Endocrinology DepartmentAngers University Hospital, Angers, France
| | - Albert David
- Genetics DepartmentNantes University Hospital, Nantes, France
| | - Sabine Baron
- Pediatric Endocrine UnitNantes University Hospital, Nantes, France
| | - Jacques Weill
- Pediatric Endocrine UnitLille University Hospital, Lille, France
| | - Bruno Leheup
- Pediatric and Genetics UnitNancy University Hospital, Vandoeuvre, France
| | - Marc Nicolino
- Pediatric Endocrinology DepartmentLyon University Pediatric Hospital, INSERM U.1060/UCBL/HCL, France
| | - Jean-Pierre Salles
- EndocrineBone Diseases, and Genetics Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France INSERM UMR 1043Centre of Pathophysiology of Toulouse Purpan (CPTP), University of Toulouse Paul Sabatier, Toulouse, France
| | - Alain Verloes
- Departments of GeneticsRobert-Debré University Hospital, APHP, Paris, France
| | - Maithé Tauber
- EndocrineBone Diseases, and Genetics Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France INSERM UMR 1043Centre of Pathophysiology of Toulouse Purpan (CPTP), University of Toulouse Paul Sabatier, Toulouse, France
| | - Hélène Cavé
- Departments of GeneticsRobert-Debré University Hospital, APHP, Paris, France
| | - Thomas Edouard
- EndocrineBone Diseases, and Genetics Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France INSERM UMR 1043Centre of Pathophysiology of Toulouse Purpan (CPTP), University of Toulouse Paul Sabatier, Toulouse, France
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Schnohr CW, Molcho M, Rasmussen M, Samdal O, de Looze M, Levin K, Roberts CJ, Ehlinger V, Krølner R, Dalmasso P, Torsheim T. Trend analyses in the health behaviour in school-aged children study: methodological considerations and recommendations. Eur J Public Health 2015; 25 Suppl 2:7-12. [PMID: 25805778 DOI: 10.1093/eurpub/ckv010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This article presents the scope and development of the Health Behaviour in School-aged Children (HBSC) study, reviews trend papers published on international HBSC data up to 2012 and discusses the efforts made to produce reliable trend analyses. METHODS The major goal of this article is to present the statistical procedures and analytical strategies for upholding high data quality, as well as reflections from the authors of this article on how to produce reliable trends based on an international study of the magnitude of the HBSC study. HBSC is an international cross-sectional study collecting data from adolescents aged 11-15 years, on a broad variety of health determinants and health behaviours. RESULTS A number of methodological challenges have stemmed from the growth of the HBSC-study, in particular given that the study has a focus on monitoring trends. Some of those challenges are considered. When analysing trends, researchers must be able to assess whether a change in prevalence is an expression of an actual change in the observed outcome, whether it is a result of methodological artefacts, or whether it is due to changes in the conceptualization of the outcome by the respondents. CONCLUSION The article present recommendations to take a number of the considerations into account. The considerations imply methodological challenges, which are core issues in undertaking trend analyses.
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Affiliation(s)
| | - Michal Molcho
- 2 School of Health Sciences, NUI Galway, Galway, Ireland
| | - Mette Rasmussen
- 3 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Oddrun Samdal
- 4 Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Margreet de Looze
- 5 Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Kate Levin
- 6 NSH Greater Glasgow & Clyde, Public Health Directorate, Glasgow, UK
| | - Chris J Roberts
- 7 Knowledge and Analytical Services, Welsh Government, Cardiff, UK
| | | | - Rikke Krølner
- 3 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Paola Dalmasso
- 9 Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - Torbjørn Torsheim
- 4 Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
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Cortey C, Godeau E, Ehlinger V, Bréhin C, Claudet I. [Choking games among 2nd and 3rd graders]. Arch Pediatr 2015; 23:45-52. [PMID: 26642965 DOI: 10.1016/j.arcped.2015.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 06/24/2015] [Accepted: 10/05/2015] [Indexed: 11/29/2022]
Abstract
UNLABELLED It is suspected that elementary school age children engage in "the choking game" or other asphyxial practices, but the prevalence is unknown. OBJECTIVE This study was conducted to determine the prevalence among 2nd and 3rd graders. METHODS Twenty-five schools in a region in Southeastern France were sampled on the following criteria: school size, rural/urban location, underprivileged neighborhood or not, and private/public school. Second and third grade classes were randomly sampled in each school. Another sample of 25 schools was selected in case a school refused to participate. A self-administered questionnaire, previously validated in two nonsampled schools, was administered in selected classes by the pediatrician leading the project. RESULTS A total of 1125 questionnaires were distributed and 95% were completed. The mean (SD) age of children was 8.3 (0.7) years. Forty percent of children reported they had already played choking games. Among all the declared players (n=401), the male to female ratio was 1.4; 13% of them played this game every day or several times a day (91% were male). This prevalence varied between schools (16-75%) and games and was significantly higher among children schooled in underprivileged neighborhoods. Seventy-six percent of non-players and 48% of players were aware of the potential life-threatening risk. CONCLUSIONS The mean prevalence in elementary school (40%) appears to be higher compared to middle and high schools (5-10%). Motivation differs in elementary school children compared to older children and teenagers. Prevention of choking games should start at elementary school and determinants leading to the continuation of such practices from elementary school to high school need to be explored.
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Affiliation(s)
- C Cortey
- Service d'accueil des urgences pédiatriques, hôpital des Enfants, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France
| | - E Godeau
- Service médical du rectorat, académie de Toulouse, 31003 Toulouse cedex 6, France; Inserm UMR1027, université Toulouse III, 37, allées J.-Guesde, 31000 Toulouse, France
| | - V Ehlinger
- Inserm UMR1027, université Toulouse III, 37, allées J.-Guesde, 31000 Toulouse, France
| | - C Bréhin
- Service d'accueil des urgences pédiatriques, hôpital des Enfants, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France
| | - I Claudet
- Service d'accueil des urgences pédiatriques, hôpital des Enfants, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France; Inserm UMR1027, université Toulouse III, 37, allées J.-Guesde, 31000 Toulouse, France.
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Tournemire A, Groussolles M, Ehlinger V, Lusque A, Morin M, Benevent JB, Arnaud C, Vayssière C. Prenasal thickness to nasal bone length ratio: effectiveness as a second or third trimester marker for Down syndrome. Eur J Obstet Gynecol Reprod Biol 2015; 191:28-32. [PMID: 26070124 DOI: 10.1016/j.ejogrb.2015.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 04/22/2015] [Accepted: 05/19/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the value of the prenasal thickness to nasal bone length ratio (PT/NBL) for detecting trisomy 21 (T21) after the first trimester. METHOD Two examiners blinded to fetal T21 status retrospectively measured prenasal thickness (PT) and nasal bone length (NBL) of T21 and control fetuses at 15-36 weeks' gestational age on two-dimensional images from all T21-screening ultrasounds from November 2010 to April 2013. ROC curve analysis and its diagnostic values determined the best cut-off value for the ratio. Interobserver reproducibility was assessed. RESULTS Good quality ultrasound profile images were available for 26 fetuses with T21 compared to 91 normal fetuses. The median PT/NBL ratio was 1.28 for T21 and 0.73 for control fetuses (p<0.0001). The PT/NBL ratio performed significantly better (AUC 0.99; 95%CI 0.97-1) than either PT (0.82; 0.73-0.91) or NBL (0.91; 0.85-0.98). The optimal PT/NBL ratio cut-off was 0.98, with a sensitivity of 88.5% [76.2-100%] and a specificity of 100%. Interobserver variability was low. CONCLUSION The PT/NBL ratio is a strong marker for detecting T21 in the second and third trimesters, significantly more effective than either indicator alone.
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Affiliation(s)
- A Tournemire
- Maternal Fetal Medicine Department, Hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France
| | - M Groussolles
- Maternal Fetal Medicine Department, Hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France
| | - V Ehlinger
- UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France
| | - A Lusque
- UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France
| | - M Morin
- Maternal Fetal Medicine Department, Hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France
| | - J B Benevent
- Cabinet d'échographie des Pharaons, Toulouse, France
| | - C Arnaud
- UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France; Clinical Epidemiology Unit, University Hospital, Toulouse, France
| | - C Vayssière
- Maternal Fetal Medicine Department, Hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France; UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France.
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Germany L, Saurel-Cubizolles MJ, Ehlinger V, Napoletano A, Alberge C, Guyard-Boileau B, Pierrat V, Genolini C, Ancel PY, Arnaud C. Social context of preterm delivery in France in 2011 and impact on short-term health outcomes: the EPIPAGE 2 cohort study. Paediatr Perinat Epidemiol 2015; 29:184-95. [PMID: 25847031 DOI: 10.1111/ppe.12189] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Low socio-economic context increases the risk of preterm delivery and may affect short-term outcomes in children born preterm. We described the social context of preterm delivery in France in 2011 and compared it with the general population of deliveries over the same period. We also studied how social context influenced pregnancy and delivery characteristics in the preterm population, and how it affected mortality and short-term morbidity in liveborn preterm children (<35 weeks). METHODS We created an individual socio-economic vulnerability index, derived from multiple correspondence analysis based on maternal social information in the French National Perinatal Survey (NPS-2010). Weighted coordinates were applied to families from the EPIPAGE 2 study, a population-based cohort of preterm infants born in 2011, to quantify the infant's exposure to socio-economic vulnerability. Multivariable logistic models were used to relate the socio-economic context to pregnancy and delivery characteristics, and to assess its impact on short-term outcomes of the infants. RESULTS Among mothers of preterm infants, gestational age decreased as socio-economic conditions worsened. In the most deprived group, women had more irregular pregnancy care, a higher prevalence of infection during pregnancy, and a lower rate of antenatal corticosteroid administration. The most deprived group was associated with a higher risk of severe morbidity for the preterm neonates. CONCLUSION Our results emphasise the need for a large population-based surveillance system to identify the most deprived mothers, and to propose appropriate follow-up and care to these women and their infants in order to enhance long-term health.
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Affiliation(s)
- Laurence Germany
- Research Unit on Perinatal Epidemiology, Childhood Disabilities and Adolescent Health, INSERM UMR 1027, Toulouse, France; Paul Sabatier University, Toulouse, France
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Cortey C, Godeau E, Ehlinger V, Claudet I. CO-66 – Prévalence des jeux de non-oxygénation (JNO) chez des élèves scolarisés en CE1 et CE2 dans l'Académie de Toulouse. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30166-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jovic S, Ehlinger V, Sentenac M, Spilka S, Navarro F, Arnaud C, Godeau E. TABACO: RELAÇÕES COM A FAMILIA, A ESCOLA E OS COLEGAS - HBSC FRANCE 2010. Psic , Saúde & Doença 2015. [DOI: 10.15309/15psd160103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Colver A, Rapp M, Eisemann N, Ehlinger V, Thyen U, Dickinson HO, Parkes J, Parkinson K, Nystrand M, Fauconnier J, Marcelli M, Michelsen SI, Arnaud C. Self-reported quality of life of adolescents with cerebral palsy: a cross-sectional and longitudinal analysis. Lancet 2015; 385:705-16. [PMID: 25301503 PMCID: PMC4606972 DOI: 10.1016/s0140-6736(14)61229-0] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Children with cerebral palsy who can self-report have similar quality of life (QoL) to their able-bodied peers. Is this similarity also found in adolescence? We examined how self-reported QoL of adolescents with cerebral palsy varies with impairment and compares with the general population, and how factors in childhood predict adolescent QoL. METHODS We report QoL outcomes in a longitudinal follow-up and cross-sectional analysis of individuals included in the SPARCLE1 (childhood) and SPARCLE2 (adolescent) studies. In 2004 (SPARCLE1), a cohort of 818 children aged 8-12 years were randomly selected from population-based cerebral palsy registers in nine European regions. We gathered data from 500 participants about QoL with KIDSCREEN (ten domains); frequency of pain; child psychological problems (Strengths and Difficulties Questionnaire); and parenting stress (Parenting Stress Index). At follow-up in 2009 (SPARCLE2), 355 (71%) adolescents aged 13-17 years remained in the study and self-reported QoL (longitudinal sample). 76 additional adolescents self-reported QoL in 2009, providing data for 431 adolescents in the cross-sectional sample. Researchers gathered data at home visits. We compared QoL against matched controls in the general population. We used multivariable regression to relate QoL of adolescents with cerebral palsy to impairments (cross-sectional analysis) and to childhood QoL, pain, psychological problems, and parenting stress (longitudinal analysis). FINDINGS Severity of impairment was significantly associated (p<0·01) with reduced adolescent QoL on only three domains (Moods and emotions, Autonomy, and Social support and peers); average differences in QoL between the least and most able groups were generally less than 0·5 SD. Adolescents with cerebral palsy had significantly lower QoL than did those in the general population in only one domain (Social support and peers; mean difference -2·7 [0·25 SD], 95% CI -4·3 to -1·4). Pain in childhood or adolescence was strongly associated with low adolescent QoL on eight domains. Childhood QoL was a consistent predictor of adolescent QoL. Child psychological problems and parenting stress in childhood or their worsening between childhood and adolescence predicted only small reductions in adolescent QoL. INTERPRETATION Individual and societal attitudes should be affected by the similarity of the QoL of adolescents with and without cerebral palsy. Adolescents with cerebral palsy need particular help to maintain and develop peer relationships. Interventions in childhood to alleviate psychological difficulties, parenting stress, and especially pain, are justified for their intrinsic value and for their longer term effect on adolescent QoL. FUNDING SPARCLE1 was funded by the European Union Research Framework 5 Program (grant number QLG5-CT-2002-00636), the German Ministry of Health GRR-58640-2/14, and the German Foundation for the Disabled Child. SPARCLE2 was funded by: Wellcome Trust WT086315 A1A (UK and Ireland); Medical Faculty of the University of Lübeck E40-2009 and E26-2010 (Germany); CNSA, INSERM, MiRe-DREES, and IRESP (France); Ludvig and Sara Elsass Foundation, The Spastics Society and Vanforefonden (Denmark); Cooperativa Sociale "Gli Anni in Tasca" and Fondazione Carivit, Viterbo (Italy); Göteborg University-Riksforbundet for Rorelsehindrade Barn och Ungdomar and the Folke Bernadotte Foundation (Sweden).
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Affiliation(s)
- Allan Colver
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
| | - Marion Rapp
- Klinik für Kinder und Jugendmedizin, Universität Lübeck, Lübeck, Germany
| | - Nora Eisemann
- Institute of Cancer Epidemiology, Universität Lübeck, Lübeck, Germany
| | | | - Ute Thyen
- Klinik für Kinder und Jugendmedizin, Universität Lübeck, Lübeck, Germany
| | - Heather O Dickinson
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Jackie Parkes
- School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, UK
| | - Kathryn Parkinson
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Malin Nystrand
- Göteborg University, The Queen Silvia Children's Hospital, Sweden
| | - Jérôme Fauconnier
- UJF-Grenoble 1/CNRS/CHU de Grenoble/TIMC-IMAG UMR 5525/Themas, France
| | | | | | - Catherine Arnaud
- INSERM, UMR 1027, Paul Sabatier University, Toulouse, France; Purpan, Clinical Epidemiology Unit, Toulouse, France
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Jovic S, Genolini C, Delpierre C, Spilka S, Ehlinger V, Ross J, Arnaud C, Godeau E. Socialization instances linked to cannabis experimentation among French teenagers. Subst Use Misuse 2014; 49:1808-19. [PMID: 25099311 DOI: 10.3109/10826084.2014.935788] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
France presents one of the highest prevalence of teenagers aged 15-year-olds who report they already have experienced cannabis in Europe. Data from the French 2010 Health Behavior in School-aged Children (HSBC) survey and environmental parameters typifying schools' neighborhoods were used to study cannabis experimentation. We conducted a two-level logistic regression (clusters being schools) on 4,175 French 8th-10th graders from 156 schools. Several individual parameters were linked to cannabis experimentation. Living in a non-intact family, feeling insufficiently monitored, having poor communication with mother and being from a family with a high socio-economic status (SES) were all associated with increased risk of cannabis experimentation. At environmental level, only being in a priority education area was linked to this behavior, without explaining differences among schools.
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Affiliation(s)
- Sonia Jovic
- 1Inserm U1027 , 37, allées Jules Guesdes, Toulouse , France
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Madkour AS, de Looze M, Ma P, Halpern CT, Farhat T, ter Bogt TFM, Ehlinger V, Nic Gabhainn S, Currie C, Godeau E. Macro-level age norms for the timing of sexual initiation and adolescents' early sexual initiation in 17 European countries. J Adolesc Health 2014; 55:114-21. [PMID: 24508092 PMCID: PMC4065809 DOI: 10.1016/j.jadohealth.2013.12.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 11/12/2013] [Accepted: 12/09/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine the relationship between country-level age norms for sexual initiation timing and early sexual initiation (ESI) among adolescent boys and girls. METHODS Nationally representative data from 17 countries that participated in the 2006/2007 European Social Survey (ESS-3, n = 33,092) and the 2005/2006 Health Behaviour in School-Aged Children Study (HBSC, n = 27,702) were analyzed. Age norms were measured as the average country-level response to an item asking the age at which ESS respondents believed someone is too young to have sexual intercourse. HBSC respondents (aged 14-16 years) self-reported age at sexual initiation, which we defined as early (<15 years) or not early (≥15 years or no initiation). Control variables included age, family affluence, perceived socioeconomic status, family living arrangement, substance use, school attachment, and country-level legal age of consent. Multivariable three-level logistic models with random intercepts were run separately by sex. RESULTS In multivariable analyses, higher overall age norms were associated with reduced likelihood of ESI among girls (AOR .60, 95% CI .45-.79); associations with ESI were stronger for parent cohort (ages 31-65 years) norms (AOR .37, 95% CI .23-.58) than for peer cohort (ages 15-20 years) norms (AOR .60, 95% CI .49-.74). For boys, overall norms were also significantly negatively associated with ESI (AOR .68, 95% CI .46-.99), as were parent cohort norms (AOR .66, 95% CI .45-.96). Peer cohort norms were not significantly related to boys' ESI. CONCLUSION Macrolevel cultural norms may impact adolescents' sexual initiation timing. Research exploring the sexual health outcomes of early initiators in countries with contrasting age norms is warranted.
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Affiliation(s)
- Aubrey Spriggs Madkour
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
| | - Margaretha de Looze
- Department of Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Heidelberglaan 2, 3584 CS Utrecht, the Netherlands
| | - Ping Ma
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, TW-19, New Orleans, LA 70112 USA
| | - Carolyn Tucker Halpern
- Department of Maternal & Child Health, Gillings School of Global Public Health, Campus Box 7445, Chapel Hill 27599-7445 USA
| | - Tilda Farhat
- Prevention Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6100 Executive Blvd Room 7B13L, MSC 7510, Bethesda, MD 20892 USA
| | - Tom F. M. ter Bogt
- Department of Interdisciplinary Social Sciences, Utrecht University, Heidelberglaan 2, 3584 CS Utrecht, The Netherlands
| | - Virginie Ehlinger
- Research Unit on Perinatal Epidemiology and Childhood disabilities, Adolescent Health, Inserm, UMR1027, Toulouse, F-31062 - Université de Toulouse III, UMR1027, Toulouse, F-31062, France
| | - Saoirse Nic Gabhainn
- Discipline of Health Promotion, Áras Moyola, National University of Ireland, Galway, University Road, Galway, Ireland
| | - Candace Currie
- Child and Adolescent Health Research Unit, School of Medicine, North Haugh, St Andrews, KY16 9TF, United Kingdom
| | - Emmanuelle Godeau
- Research Unit on Perinatal Epidemiology and Childhood disabilities, Adolescent Health, Inserm, UMR1027, Toulouse, F-31062 - Université de Toulouse III, UMR1027, Toulouse, F-31062, France,Service médical du rectorat de Toulouse, Rectorat annexe – Bat F – Bd A. Duportal – BP 40303 - 31003 Toulouse cedex 6, France
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Bouhanick B, Ehlinger V, Delpierre C, Chamontin B, Lang T, Kelly-Irving M. Mode of delivery at birth and the metabolic syndrome in midlife: the role of the birth environment in a prospective birth cohort study. BMJ Open 2014; 4:e005031. [PMID: 24833693 PMCID: PMC4025456 DOI: 10.1136/bmjopen-2014-005031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES The aim of this study is to examine the hypothesis that mode of delivery at birth may be associated with metabolic disorders in adult midlife. SETTING Population cohort study PARTICIPANTS The National Child Development Study consists of individuals born during 1 week in 1958 in Great Britain. Respondents with biomedical data on the metabolic syndrome at age 45 were included. OUTCOME MEASURE The metabolic syndrome was defined based on the National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP) III classification. RESULTS 7156 were born naturally; among the caesarean births, 106 were non-elective and 85 were elective caesareans. The metabolic syndrome is present in 37.7% of those born by non-elective caesareans, 25.9% of those born by elective caesarean and 27.5% of those born by vaginal delivery. In a multivariate logistic regression model adjusted for antenatal factors, birth history, mother's characteristics and the socioeconomic environment at birth, only birth by non-elective caesarean remained associated with the metabolic syndrome in adulthood compared with vaginal delivery (OR 1.51, 95% CI 1.00 to 2.30). Mother's obesity (OR 1.61, 95% CI 1.12 to 2.34) and low maternal education level (OR 1.47, 95% CI 1.30 to 1.67) were also independently associated with midlife metabolic syndrome. CONCLUSIONS Birth by non-elective caesarean in 1958 may be associated with metabolic syndrome in adulthood after adjusting for prior confounding factors. We suggest that the birth context of emergency caesareans in 1958 is suggestive of a 'fetal stress' mechanism affecting health across the lifecourse.
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Affiliation(s)
- Béatrice Bouhanick
- Service de Médecine Interne et HTA, CHU Rangueil, Toulouse, France
- INSERM UMR 1027, Toulouse, France
| | - Virginie Ehlinger
- INSERM UMR 1027, Toulouse, France
- Université Toulouse III, UMR1027, Toulouse, France
| | - Cyrille Delpierre
- INSERM UMR 1027, Toulouse, France
- Université Toulouse III, UMR1027, Toulouse, France
| | - Bernard Chamontin
- Service de Médecine Interne et HTA, CHU Rangueil, Toulouse, France
- INSERM UMR 1027, Toulouse, France
| | - Thierry Lang
- INSERM UMR 1027, Toulouse, France
- Université Toulouse III, UMR1027, Toulouse, France
- Service d'Epidémiologie, CHU Toulouse, Toulouse, France
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Jovic S, Delpierre C, Ehlinger V, Sentenac M, Young H, Arnaud C, Godeau E. Associations between life contexts and early sexual initiation among young women in France. Perspect Sex Reprod Health 2014; 46:31-39. [PMID: 24433395 DOI: 10.1363/46e0214] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
CONTEXT Early sexual initiation (before age 16) has been linked to an increased risk of teenage pregnancy and STDs. Most research on correlates of early sexual initiation is from the United States; no similar work has been conducted in France, where the sociocultural environment differs. METHODS Cross-sectional data from the 2010 Health Behaviour in School-Aged Children survey were used to examine the relationships of personal, family, peer, school and neighborhood characteristics with early sexual initiation among 1,094 French females in grades 8-10. Two-level logistic regressions were used to identify associations. RESULTS Twenty-five percent of respondents had had sex before age 16. Early sexual initiation was primarily -associated with individual-level characteristics. Young women had an elevated likelihood of having initiated sex early if they went out after school at least four times a week (odds ratio, 2.0), had repeated a grade (1.8), lived with a single parent or in a stepfamily (1.8 and 1.5, respectively), perceived a low level of parental monitoring (1.6) or had two or more male friends (2.8). At the environmental level, respondents who attended school in areas with a high proportion of residents who were foreigners had a reduced likelihood of having initiated sex early (0.5-0.6). CONCLUSIONS Although early sexual initiation in France was essentially linked to individual-level variables, further research is needed to understand its relationship with neighborhood characteristics. Such studies should include additional environmental variables, test new hypotheses and employ a longitudinal approach.
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Affiliation(s)
- Sonia Jovic
- Sonia Jovic, Cyrille Delpierre and Mariane Sentenac are epidemiologists; Catherine Arnaud is a physician and an epidemiologist; and Virginie Ehlinger is a biostatistician-all at INSERM U1027, Toulouse, France
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Chollet C, Ehlinger V, Dupuy M, Guitard C, Leautier D, Jouret B, Arnaud C, Tauber M. Prévalence du surpoids chez le jeune enfant : analyse des données des bilans de santé à 3-4 ans en Haute-Garonne. Arch Pediatr 2013; 20:1187-1192. [PMID: 24090670 DOI: 10.1016/j.arcped.2013.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 07/17/2013] [Accepted: 08/13/2013] [Indexed: 11/15/2022]
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