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1.
  • Bornehag, Carl-Gustaf, 1957-, et al. (författare)
  • The SELMA study : a birth cohort study in Sweden following more than 2000 mother-child pairs
  • 2012
  • Ingår i: Paediatric and Perinatal Epidemiology. - Hoboken, USA : Wiley-Blackwell. - 0269-5022 .- 1365-3016. ; 26:5, s. 456-467
  • Tidskriftsartikel (refereegranskat)abstract
    • Background:  This paper describes the background, aim and study design for the Swedish SELMA study that aimed to investigate the importance of early life exposure during pregnancy and infancy to environmental factors with a major focus on endocrine disrupting chemicals for multiple chronic diseases/disorders in offspring.Methods: The cohort was established by recruiting women in the 10th week of pregnancy. Blood and urine from the pregnant women and the child and air and dust from home environment from pregnancy and infancy period have been collected. Questionnaires were used to collect information on life styles, socio-economic status, living conditions, diet and medical history.Results: Of the 8394 reported pregnant women, 6658 were invited to participate in the study. Among the invited women, 2582 (39%) agreed to participate. Of the 4076 (61%) non-participants, 2091 women were invited to a non-respondent questionnaire in order to examine possible selection bias. We found a self-selection bias in the established cohort when compared with the non-participant group, e.g. participating families did smoke less (14% vs. 19%), had more frequent asthma and allergy symptoms in the family (58% vs. 38%), as well as higher education among the mothers (51% vs. 36%) and more often lived in single-family houses (67% vs. 60%).Conclusions: These findings indicate that the participating families do not fully represent the study population and thus, the exposure in this population. However, there is no obvious reason that this selection bias will have an impact on identification of environmental risk factors.
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2.
  • Li, Xinjun, et al. (författare)
  • Parental occupation and preterm births: a nationwide epidemiological study in Sweden.
  • 2010
  • Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022 .- 1365-3016. ; 24:6, s. 555-563
  • Tidskriftsartikel (refereegranskat)abstract
    • The hypothesis was that some occupations could lead to preterm birth (PTB) because of potential exposures to various agents. The objective in this nationwide follow-up study was to analyse the association between PTB and parental occupational groups, controlling for potential confounders. Data from the Swedish Medical Birth Register, in which all children born in Sweden from 1990 onward are registered with their parents, were linked to census data. Inclusion criteria for the study population were employment (both women and men) and age >20 years (women). There were 816,743 first singleton live births from 1990 to 2004, of whom 43,956 were PTBs. A total of 7659 of the 43,956 PTBs were very PTBs. Odds ratios (ORs) with 95% confidence intervals were calculated separately for mothers and fathers to estimate the odds of PTB and very PTB in 51 occupational groups (reference groups: mothers or fathers who were 'Technical, science research-related workers and physicians') and by family income level. Women and men with low family incomes had increased ORs of PTB and very PTB. Significantly increased ORs of PTB (including very PTB) were found in four maternal and nine paternal occupational groups after accounting for family income, geographic region of residence, civil status, smoking habits, maternal age at infant's birth and period of birth. Further studies should examine specific agents in those parental occupations that were associated with increased odds of PTB and very PTB.
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  • Lilja, Monica (författare)
  • School attainment of children who had a single umbilical artery at birth
  • 2010
  • Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022 .- 1365-3016. ; 24:2, s. 166-170
  • Tidskriftsartikel (refereegranskat)abstract
    • P>Lilja M. School attainment of children who had a single umbilical artery at birth. Paediatric and Perinatal Epidemiology 2010; 24: 166-170. To the best of our knowledge, this is the first registry study of school achievements among children born with a single umbilical artery (SUA). A total of 1600 infants born with SUA during 1983-86 were studied. We linked the Swedish Medical Birth Registry with the Swedish School Registry, which contains the school grades of all children in Sweden when leaving compulsory school. Risks were estimated as odds ratios (OR) using the Mantel-Haenzel procedure, after adjustment for four potential confounders: year of birth, maternal age, parity and maternal education. There was a 60% excess of children born with SUA who did not complete compulsory school after removal of infants born preterm, small-for-gestational age and low Apgar score (OR = 1.60 [95% confidence interval 1.28, 2.00]). When sports and the three core school subjects (mathematics, English and Swedish) were studied, there was an increased risk for 'not passed' in all subjects except sport and a slight decrease in the probability of achieving 'passed with distinction or excellence'. In the three core subjects there was an association with gender, boys with SUA being more likely to have 'not passed' than girls. In conclusion the children born with SUA are more likely than children born with three vessels to show impaired school achievements.
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  • Ali Khan, A., et al. (författare)
  • Does in utero exposure to synthetic glucocorticoids influence birthweight, head circumference and birth length? : A systematic review of current evidence in humans
  • 2011
  • Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022 .- 1365-3016. ; 25:1, s. 20-36
  • Forskningsöversikt (refereegranskat)abstract
    • Synthetic glucocorticoids are the mainstay treatment for stimulating lung maturation in threatened preterm delivery. Animal studies suggest that in utero exposure to glucocorticoids leads to a reduction in birth size. Smaller birthweight has been associated with higher risk of many chronic diseases. Therefore, the authors undertook a systematic review of human studies examining the association between synthetic glucocorticoid treatment and birth size. Medline, EMBASE, PubMed, Cochrane, Google scholar and Institute of Life Science databases were searched for studies published between 1978 and 2009 investigating the association between synthetic glucocorticoids and birthweight, head circumference, birth length and ponderal index. All studies controlling for gestational age were examined. Seventeen studies were included in the analysis. Nine out of 17 studies reported a reduction in birthweight (range 12-332 g), five of nine a reduction of head circumference (range 0.31-1.02 cm) and two of four a reduction of 0.8 cm in birth length. Despite methodological inconsistencies and limitations that impede clear conclusions, the evidence suggests an association between in utero exposure to synthetic glucocorticoids and reduced birth size.
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  • Graner, Sophie, 1971-, et al. (författare)
  • Adverse perinatal and neonatal outcomes and their determinants in rural Vietnam 1999-2005
  • 2010
  • Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022 .- 1365-3016. ; 24:6, s. 535-545
  • Tidskriftsartikel (refereegranskat)abstract
    • Population-based estimations of perinatal and neonatal outcomes are sparse in Vietnam. There are no previously published data on small for gestational age (SGA) infants. A rural population in northern Vietnam was investigated from 1999 to 2005 (n = 5521). Based on the birthweight distributions within the population under study, reference curves for intrauterine growth for Vietnamese infants were constructed and the prevalence and distribution of SGA was calculated for each sex. Neonatal mortality was estimated as 11.6 per 1000 live births and the perinatal mortality as 25.0 per 1000 births during the study period. The mean birthweight was 3112 g and the prevalence of low birthweight was 5.0%. The overall prevalence of SGA was 6.4%. SGA increased with gestational age and was 2.2%, 4.5% and 27.1% for preterm, term and post-term infants, respectively. Risk factors for SGA were post-term birth: adjusted odds ratio (AOR) 7.75 [95% CI 6.02, 9.98], mothers in farming occupations AOR 1.72 [95% CI 1.21, 2.45] and female infant AOR 1.61 [95% CI 1.27, 2.03]. There was a pronounced decrease in neonatal mortality after 33 weeks of gestation. Suggested interventions are improved prenatal identification of SGA infants by ultrasound investigation for fetal growth among infants who do not follow their expected clinical growth curve at the antenatal clinic. Other suggestions include allocating a higher proportion of preterm deliveries to health facilities with surgical capacity and neonatal care.
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  • Sobko, Tanja, et al. (författare)
  • Neonatal sepsis, antibiotic therapy and later risk of asthma and allergy
  • 2010
  • Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022 .- 1365-3016. ; 24:1, s. 88-92
  • Tidskriftsartikel (refereegranskat)abstract
    • P>Sobko T, Schiott J, Ehlin A, Lundberg J, Montgomery S, Norman M. Neonatal sepsis, antibiotic therapy and later risk of asthma and allergy. Paediatric and Perinatal Epidemiology 2010; 24: 88-92. Neonatal sepsis and early antibiotic therapy affect bacterial colonisation and immune activation after birth. This could have implications for later risk of allergy and asthma. Using a validated questionnaire (International Study of Asthma and Allergies in Children, ISAAC), we screened for asthma and allergy in three cohorts (total n = 834; median age 12, range 7-23 years) with different perinatal exposures as regards infection and antibiotics. Asthma, but not hay fever, was more prevalent after neonatal sepsis with adjusted odds ratio (OR) 1.63 [95% confidence interval (CI) 1.04, 2.56] and early antibiotic therapy (OR 1.48 [0.93, 2.35]) as compared with a control group. There was a trend towards increased atopic eczema after neonatal sepsis (OR = 1.39 [CI = 0.98, 1.98]). We conclude that neonatal sepsis is associated with an increased risk for later development of asthma. Early antibiotic exposure may contribute to this association.
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13.
  • Sovio, Ulla, et al. (författare)
  • Social determinants of infant mortality in a historical Swedish cohort
  • 2012
  • Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022 .- 1365-3016. ; 26:5, s. 408-420
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Infant mortality rates have fallen considerably in the past decades. However, because of sparseness of historical data, it is unclear how social differences in infant mortality have changed over time.Methods: The aim of this study was to assess the association between prenatal social determinants and infant mortality in a Swedish cohort of 13 741 singletons born between 1915 and 1929. Associations and potential mediation of these determinants through other maternal and birth factors were studied using Cox regression. Analyses were repeated for deaths within the neonatal and post-neonatal periods.Results: Mother's single marital status, high parity, low birthweight (LBW), low gestational age and male sex were associated with infant mortality in fully adjusted models, whereas the associations of maternal social class, region of residence and maternal age appeared to be largely mediated through other variables. Contrary to studies reporting a ‘LBW paradox’, no interactions between gestational age or birthweight and maternal social characteristics on infant mortality were observed in this study. High maternal age, LBW and low/high gestational age were associated with neonatal mortality, whereas single marital status, high parity, LBW, low gestational age and male sex were associated with post-neonatal mortality. An association of family social class with post-neonatal mortality was largely mediated by other maternal variables.Conclusions: Our findings of determinants of neonatal and post-neonatal mortality in 1915–1929 are strikingly consistent with results from contemporary cohorts. On the other hand, contrary to most recent findings, there is no evidence of a LBW paradox in this historical cohort.
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  • Stemann Larsen, Pernille, et al. (författare)
  • Pregnancy and Birth Cohort Resources in Europe: a Large Opportunity for Aetiological Child Health Research
  • 2013
  • Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley-Blackwell. - 0269-5022 .- 1365-3016. ; 27:4, s. 393-414
  • Forskningsöversikt (refereegranskat)abstract
    • Background During the past 25 years, many pregnancy and birth cohorts have been established. Each cohort provides unique opportunities for examining associations of early-life exposures with child development and health. However, to fully exploit the large amount of available resources and to facilitate cross-cohort collaboration, it is necessary to have accessible information on each cohort and its individual characteristics. The aim of this work was to provide an overview of European pregnancy and birth cohorts registered in a freely accessible database located at http://www.birthcohorts.net. Methods European pregnancy and birth cohorts initiated in 1980 or later with at least 300 mother-child pairs enrolled during pregnancy or at birth, and with postnatal data, were eligible for inclusion. Eligible cohorts were invited to provide information on the data and biological samples collected, as well as the timing of data collection. Results In total, 70 cohorts were identified. Of these, 56 fulfilled the inclusion criteria encompassing a total of more than 500000 live-born European children. The cohorts represented 19 countries with the majority of cohorts located in Northern and Western Europe. Some cohorts were general with multiple aims, whilst others focused on specific health or exposure-related research questions. Conclusion This work demonstrates a great potential for cross-cohort collaboration addressing important aspects of child health. The web site, http://www.birthcohorts.net, proved to be a useful tool for accessing information on European pregnancy and birth cohorts and their characteristics.
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18.
  • Calling, Susanna, et al. (författare)
  • Socioeconomic inequalities and infant mortality of 46 470 preterm infants born in Sweden between 1992 and 2006
  • 2011
  • Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022. ; 25:4, s. 357-365
  • Tidskriftsartikel (refereegranskat)abstract
    • Socioeconomic inequalities and infant mortality of 46 470 preterm infants born in Sweden between 1992 and 2006. Paediatric and Perinatal Epidemiology 2011; 25: 357-365. Studies on possible sociodemographic inequities in the survival of preterm infants are scarce. Individual and neighbourhood sociodemographic factors are related to preterm birth and to infant mortality in full-term infants. The aim here was to examine whether infant mortality in Swedish preterm infants is related to individual and neighbourhood sociodemographic factors, and to study whether the hypothesised association between neighbourhood deprivation and infant mortality persists after accounting for individual sociodemographic factors. The study included 46 470 infants with a gestational length of < 37 weeks, born in Sweden between 1992 and 2006. Neighbourhood deprivation was assessed by an index (education, income, unemployment, welfare assistance) in small geographical units, and categorised into low, moderate and high deprivation. Adjusted odds ratios for infant mortality were examined in relation to individual and neighbourhood sociodemographic factors. After adjusting for maternal age, infant mortality was associated with the following sociodemographic variables: maternal non-married/non-cohabiting status, low family income, low maternal education and rural status. After full adjustment, the odds ratio [95% confidence interval] was 2.98 [2.42, 3.67] for low family income compared with high family income. An increase in infant mortality was also associated with high neighbourhood deprivation; however, this increased risk no longer remained statistically significant after adjusting for individual sociodemographic factors. In conclusion, this study showed an increased infant mortality in preterm infants born to women with a less favourable sociodemographic profile.
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19.
  • Carlsson Fagerberg, Marie, et al. (författare)
  • Indications for first caesarean and delivery mode in subsequent trial of labour.
  • 2013
  • Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022. ; 27:1, s. 72-80
  • Tidskriftsartikel (refereegranskat)abstract
    • A previous caesarean delivery is no longer an indication per se for a subsequent, planned caesarean. We performed this study to identify women suitable for trial of labour after caesarean (TOLAC), investigating the association between the indication for the first caesarean and the risk of unplanned caesarean in the second pregnancy.
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  • Juarez, Sol Pia, et al. (författare)
  • The quality of vital statistics for studying perinatal health: the spanish case
  • 2012
  • Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022. ; 26:4, s. 310-315
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Birthweight and gestational age are key indicators for perinatal health obtained through the birth certificate. Knowing the validity of birth certificate data is crucial when identifying needs and evaluating birth outcomes. In Spain, vital information is reported by parents and is not checked for consistency with any hospital document. Therefore, to perform a validation study and describe the variables associated with misreporting is essential to improve the quality of birth certificates. Methods: A database was created using birth information from hospital medical records that were individually linked with the Spanish National Institute of Statistics (INE) birth certificate files. Measures of reliability and validity were used to compare the data from the two sources. Logistic regression models were adjusted to model the odds of being misreported in birthweight and gestational age, controlling for relevant variables. Results: INE overestimated the prevalence of birthweight and gestational age. The degree of agreement between the two sources was good for most gestational age groups (Kappa = 0.74), very good for the very preterm (Kappa = 0.85) and very good also for all categories of birthweight (Kappa = 0.88). Misreporting was significantly higher among immigrants, unmarried mothers and girls. Being a preterm birth increased the odds of being declared with errors in gestational age; having low birthweight and missing information on gestational age were associated with misreporting birthweight. Conclusions: The reliability of INE information could be greatly improved if hospitals included birthweight and gestational age on the document provided to parents for registering the birth.
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22.
  • Mattsson, Kristina, et al. (författare)
  • Influence of Maternal and Paternal Birthweight on Offspring Birthweight - a Population-based Intergenerational Study.
  • 2013
  • Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022. ; 27:2, s. 138-144
  • Tidskriftsartikel (refereegranskat)abstract
    • The correlation between infant birthweight and parental birthweight has received substantial interest. However, fewer studies including the birthweight of the father have had access to large sets of population-based data. The objective of this study is to examine the influence of maternal and paternal birthweight on the birthweight of the offspring in the context of other birthweight determinants, with a special focus on the contribution of paternal birthweight.
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  • Morken, Nils-Halvdan, et al. (författare)
  • Predicting Risk of Spontaneous Preterm Delivery in Women with a Singleton Pregnancy
  • 2014
  • Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022. ; 28:1, s. 11-22
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundPrediction of a woman's risk of a spontaneous preterm delivery (PTD) is a core challenge and an unresolved problem in today's obstetric practice. The objective of this study was to develop prediction models for spontaneous PTD (<37 weeks). MethodsA population-based register study of women born in Sweden with spontaneous onset of delivery was designed using Swedish Medical Birth Register data for 1992-2008. Predictive variables were identified by multiple logistic regression analysis, and outputs were used to calculate adjusted likelihood ratios in primiparous (n=199272) and multiparous (n=249580) singleton pregnant women. The predictive ability of each model was validated in a separate test sample for primiparous (n=190936) and multiparous (n=239203) women, respectively. ResultsFor multiparous women, the area under the ROC curve (AUC) of 0.74 [95% confidence interval (CI) 0.73, 0.74] indicated a satisfying performance of the model, while for primiparous women, it was rather poor {AUC: 0.58 [95% CI 0.57, 0.58]}. For both primiparous and multiparous women, the prediction models were quite good for pregnancies with comparatively low risk for spontaneous PTD, whereas more limited to predict pregnancies with 30% risk of spontaneous PTD. ConclusionsSpontaneous PTD is difficult to predict in multiparous women and nearly impossible in primiparous, by using this statistical method in a large and unselected sample. However, adding clinical data (like cervical length) may in the future further improve its predictive performance.
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