| 1. |
- Crump, Casey, et al.
(författare)
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Mortality in persons with mental disorders is substantially overestimated using inpatient psychiatric diagnoses
- 2013
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Ingår i: Journal of Psychiatric Research. - : Elsevier BV. - 1879-1379 .- 0022-3956. ; 47:10, s. 1298-1303
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Tidskriftsartikel (refereegranskat)abstract
- Mental disorders are associated with premature mortality, and the magnitudes of risk have commonly been estimated using hospital data. However, psychiatric patients who are hospitalized have more severe illness and do not adequately represent mental disorders in the general population. We conducted a national cohort study using outpatient and inpatient diagnoses for the entire Swedish adult population (N = 7,253,516) to examine the extent to which mortality risks are overestimated using inpatient diagnoses only. Outcomes were all-cause and suicide mortality during 8 years of follow-up (2001-2008). There were 377,339 (5.2%) persons with any inpatient psychiatric diagnosis, vs. 680,596 (9.4%) with any inpatient or outpatient diagnosis, hence 44.6% of diagnoses were missed using inpatient data only. When including and accounting for prevalent psychiatric cases, all-cause mortality risk among persons with any mental disorder was overestimated by 153% using only inpatient diagnoses (adjusted hazard ratio [aHR], 5.89; 95% Cl, 5.85-5.92) vs. both inpatient and outpatient diagnoses (aHR, 5.11; 95% Cl, 5.08-5.14). Suicide risk was overestimated by 18.5% (aHRs, 23.91 vs. 20.18), but this varied widely by specific disorders, from 4.4% for substance use to 49.1% for anxiety disorders. The sole use of inpatient diagnoses resulted in even greater overestimation of all-cause or suicide mortality risks when prevalent cases were unidentified (similar to 20-30%) or excluded (similar to 25-40%). However, different methods for handling prevalent cases resulted in only modest variation in risk estimates when using both inpatient and outpatient diagnoses. These findings have important implications for the interpretation of hospital-based studies and the design of future studies. (C) 2013 Elsevier Ltd. All rights reserved.
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| 2. |
- Crump, Casey, et al.
(författare)
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Aerobic fitness, muscular strength and obesity in relation to risk of heart failure
- 2017
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Ingår i: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 103:22, s. 1780-1787
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Tidskriftsartikel (refereegranskat)abstract
- Objective Low physical fitness and obesity have been associated with higher risk of developing heart failure (HF), but their interactive effects are unknown. Elucidation of interactions among these common modifiable factors may help facilitate more effective primary prevention. Methods We conducted a national cohort study to examine the interactive effects of aerobic fitness, muscular strength and body mass index (BMI) among 1 330 610 military conscripts in Sweden during 1969-1997 (97%-98% of all 18-year-old men) on risk of HF identified from inpatient and outpatient diagnoses through 2012 (maximum age 62 years). Results There were 11 711 men diagnosed with HF in 37.8 million person-years of follow-up. Low aerobic fitness, low muscular strength and obesity were independently associated with higher risk of HF, after adjusting for each other, socioeconomic factors, other chronic diseases and family history of HF. The combination of low aerobic fitness and low muscular strength (lowest vs highest tertiles) was associated with a 1.7-fold risk of HF (95% CI 1.6 to 1.9; p<0.001; incidence rates per 100 000 person-years, 43.2 vs 10.8). These factors had positive additive and multiplicative interactions (p<0.001) and were associated with increased risk of HF even among men with normal BMI. Conclusions Low aerobic fitness, low muscular strength and obesity at the age of 18 years were independently associated with higher risk of HF in adulthood, with interactive effects between aerobic fitness and muscular strength. These findings suggest that early-life interventions may help reduce the long-term risk of HF and should include both aerobic fitness and muscular strength, even among persons with normal BMI.
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| 3. |
- Crump, Casey, et al.
(författare)
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Cardiorespiratory fitness and long-term risk of sleep apnea : A national cohort study
- 2019
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Ingår i: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 28:6
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Tidskriftsartikel (refereegranskat)abstract
- Sleep apnea is increasing in prevalence, and is an important cause of cardiometabolic diseases and mortality worldwide. Its only established modifiable risk factor is obesity; however, up to half of all sleep apnea cases may occur in non-obese persons, and hence there is a pressing need to identify other modifiable risk factors to facilitate more effective prevention. We sought to examine, for the first time, cardiorespiratory fitness in relation to the risk of sleep apnea, independent of obesity. A national cohort study was conducted to examine cardiorespiratory fitness in all 1,547,478 Swedish military conscripts during 1969–1997 (97%–98% of all 18-year-old men) in relation to risk of sleep apnea through 2012 (maximum age 62 years). Cardiorespiratory fitness was measured as maximal aerobic workload in Watts, and sleep apnea was identified from nationwide outpatient and inpatient diagnoses. A total of 44,612 (2.9%) men were diagnosed with sleep apnea in 43.7 million person-years of follow-up. Adjusting for age, height, weight, socioeconomic factors and family history of sleep apnea, low cardiorespiratory fitness at age 18 years was associated with a significantly increased risk of sleep apnea in adulthood (lowest versus highest cardiorespiratory fitness tertile: incidence rate ratio, 1.44; 95% confidence interval, 1.40–1.49; p < 0.001; continuous cardiorespiratory fitness per 100 Watts: incidence rate ratio, 0.71; 95% confidence interval, 0.70–0.73; p < 0.001). An increased risk was observed even among men with normal body mass index (lowest versus highest cardiorespiratory fitness tertile: incidence rate ratio, 1.30; 95% confidence interval, 1.26–1.35; p < 0.001). These findings identify low cardiorespiratory fitness early in life as a new modifiable risk factor for development of sleep apnea in adulthood.
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| 4. |
- Crump, Casey, et al.
(författare)
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Comorbidities and Mortality in Bipolar Disorder A Swedish National Cohort Study
- 2013
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Ingår i: JAMA Psychiatry. - : American Medical Association (AMA). - 2168-6238 .- 2168-622X. ; 70:9, s. 931-939
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Bipolar disorder is associated with premature mortality, but the specific causes and underlying pathways are unclear. OBJECTIVE To examine the physical health effects of bipolar disorder using outpatient and inpatient data for a national population. DESIGN, SETTING, AND PARTICIPANTS National cohort study of 6 587 036 Swedish adults, including 6618 with bipolar disorder. MAIN OUTCOMES AND MEASURES Physical comorbidities diagnosed in any outpatient or inpatient setting nationwide and mortality (January 1, 2003, through December 31, 2009). RESULTS Women and men with bipolar disorder died 9.0 and 8.5 years earlier on average than the rest of the population, respectively. All-cause mortality was increased 2-fold among women (adjusted hazard ratio [aHR], 2.34; 95% CI, 2.16-2.53) and men (aHR, 2.03; 95% CI, 1.85-2.23) with bipolar disorder, compared with the rest of the population. Patients with bipolar disorder had increased mortality from cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD), influenza or pneumonia, unintentional injuries, and suicide for both women and men and cancer for women only. Suicide risk was 10-fold among women (aHR, 10.37; 95% CI, 7.36-14.60) and 8-fold among men (aHR, 8.09; 95% CI, 5.98-10.95) with bipolar disorder, compared with the rest of the population. Substance use disorders contributed only modestly to these findings. The association between bipolar disorder and mortality from chronic diseases (ischemic heart disease, diabetes, COPD, or cancer) was weaker among persons with a prior diagnosis of these conditions (aHR, 1.40; 95% CI, 1.26-1.56) than among those without a prior diagnosis (aHR, 2.38; 95% CI, 1.95-2.90; P-interaction = .01). CONCLUSIONS AND RELEVANCE In this large national cohort study, patients with bipolar disorder died prematurely from multiple causes, including cardiovascular disease, diabetes, COPD, influenza or pneumonia, unintentional injuries, and suicide. However, chronic disease mortality among those with more timely medical diagnosis approached that of the general population, suggesting that better provision of primary medical care may effectively reduce premature mortality among persons with bipolar disorder.
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| 5. |
- Crump, Casey, et al.
(författare)
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Comorbidities and Mortality in Persons With Schizophrenia: A Swedish National Cohort Study
- 2013
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Ingår i: American Journal of Psychiatry. - : American Psychiatric Association Publishing. - 1535-7228 .- 0002-953X. ; 170:3, s. 324-333
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Schizophrenia is associated with premature mortality, but the specific causes and pathways are unclear. The authors used outpatient and inpatient data for a national population to examine the association between schizophrenia and mortality and comorbidities. Method: This was a national cohort study of 6,097,834 Swedish adults, including 8,277 with schizophrenia, followed for 7 years (2003-2009) for mortality and comorbidities diagnosed in any outpatient or inpatient setting nationwide. Results: On average, men with schizophrenia died 15 years earlier, and women 12 years earlier, than the rest of the population, and this was not accounted for by unnatural deaths. The leading causes were ischemic heart disease and cancer. Despite having twice as many health care system contacts, schizophrenia patients had no increased risk of nonfatal ischemic heart disease or cancer diagnoses, but they had an elevated mortality from ischemic heart disease (adjusted hazard ratio for women, 3.33 [95% CI=2.73-4.05]; for men, 2.20 [95%, CI=1.83-2.65]) and cancer (adjusted hazard ratio for women, 1.71 [95% CI=1.38-2.10; for men, 1.44 [95% CI=1.15-1.80]). Among all people who died from ischemic heart disease or cancer, schizophrenia patients Were less likely than others to have been diagnosed previously with these conditions (for ischemic heart disease, 26.3% compared with 43.7%; for cancer, 73.9% compared with 82.3%). The association between schizophrenia and mortality was stronger among women and the employed. Lack of antipsychotic treatment was also associated with elevated mortality.. Conclusions: Schizophrenia patients had markedly premature mortality, and the leading causes were ischemic heart disease and cancer, which appeared to be under-diagnosed. Preventive interventions should prioritize primary health care tailored to this population, including more effective risk modification and screening for cardiovascular disease and cancer. (Am J Psychiatty 2013; 170:324-333)
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| 6. |
- Crump, Casey, et al.
(författare)
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Exercise is medicine : Primary care counseling on aerobic fitness and muscle strengthening
- 2019
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Ingår i: Journal of the American Board of Family Medicine. - : American Board of Family Medicine (ABFM). - 1557-2625 .- 1558-7118. ; 32:1, s. 103-107
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Tidskriftsartikel (refereegranskat)abstract
- Patient counseling on physical fitness remains underutilized in primary care, despite its clinical and cost effectiveness. Most counseling interventions have focused on aerobic activity and neglected another vital component of physical fitness, muscle strengthening, which has recently been shown to be independently protective against cardiometabolic diseases and premature mortality. This article reviews the latest scientific evidence and makes recommendations toward a more comprehensive approach for promoting physical fitness in primary care. Given the high prevalence and wide-ranging health impacts of physical inactivity, counseling on physical fitness should be a standard part of wellness promotion and disease prevention and treatment for all patients. Interventions that include muscle strengthening will have a significantly greater impact on health outcomes than those focused on aerobic fitness alone. Counseling to promote both aerobic fitness and muscle strengthening is indicated for all patients, irrespective of body weight, and should begin early in life and continue across the life course.
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| 7. |
- Crump, Casey, et al.
(författare)
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Fetal growth and subsequent maternal risk of thyroid cancer.
- 2016
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136. ; 138:5, s. 1085-1093
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Tidskriftsartikel (refereegranskat)abstract
- Thyroid cancer has peak incidence among women of reproductive age, and growth factors, which have procarcinogenic properties, may play an important etiologic role. However, the association between fetal growth rate during a woman's pregnancy and her subsequent risk of thyroid cancer has not been previously examined. We conducted a national cohort study of 1,837,634 mothers who had a total of 3,588,497 live-births in Sweden in 1973-2008, followed up for thyroid cancer incidence through 2009. There were 2,202 mothers subsequently diagnosed with thyroid cancer in 36.8 million person-years of follow-up. After adjusting for maternal age, height, weight, smoking, and sociodemographic factors, high fetal growth (birth weight standardized for gestational age and sex) was associated with a subsequent increased risk of thyroid cancer in the mother (incidence rate ratio [IRR] per additional 1 standard deviation, 1.05; 95% CI, 1.01-1.09; P=0.02). Each 1,000 g increase in the infant's birth weight was associated with a 13% increase in the mother's subsequent risk of thyroid cancer (IRR, 1.13; 95% CI, 1.05-1.22; P=0.001). These findings appeared to involve both papillary and follicular subtypes, and did not vary significantly by the mother's height, weight, or smoking status. In this large national cohort study, high fetal growth during a woman's pregnancy was independently associated with a subsequent increased risk of her developing thyroid cancer. If confirmed, these findings suggest an important role of maternal growth factors in the development of thyroid cancer, and potentially may help facilitate the identification of high-risk subgroups of women. This article is protected by copyright. All rights reserved. © 2014 Wiley Periodicals, Inc.
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| 8. |
- Crump, Casey, et al.
(författare)
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Gestational age at birth and mortality from infancy into mid-adulthood : a national cohort study
- 2019
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Ingår i: The Lancet Child and Adolescent Health. - 2352-4642. ; 3:6, s. 408-417
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Tidskriftsartikel (refereegranskat)abstract
- Background: Breakthroughs in the treatment of preterm birth approximately 40 years ago have enabled a generation of preterm survivors to now reach mid-adulthood. Understanding their health sequelae is essential for guiding their long-term care. We did a study to examine preterm birth in relation to mortality into mid-adulthood. Methods: A national cohort study was done of all 4 296 814 singleton livebirths in Sweden between 1973 and 2015, who were followed up for mortality through Dec 31, 2017 (maximum age 45 years). Cox regression was used to examine gestational age at birth in relation to all-cause and cause-specific mortality, and cosibling analyses assessed for potential confounding by shared familial (genetic or environmental)factors. Findings: In 103·5 million person-years of follow-up, 43 916 (1·0%)deaths were reported. Gestational age at birth was inversely associated with mortality from infancy to mid-adulthood. Relative to full-term birth (39–41 weeks), the adjusted hazard ratios for mortality associated with gestational age at birth were: 66·14 (95% CI 63·09–69·34)for extremely preterm (22–27 weeks), 8·67 (8·32–9·03)for very preterm (28–33 weeks), 2·61 (2·52–2·71)for late preterm (34–36 weeks), and 1·34 (1·30–1·37)for early term (37–38 weeks), from birth to age 45 years; and 2·04 (0·92–4·55)for extremely preterm, 1·48 (1·17–1·87)for very preterm, 1·22 (1·07–1·39)for late preterm, and 1·16 (1·08–1·25)for early term, at ages 30–45 years. Preterm birth accounted for more deaths among males than females (additive interaction p<0·001). Multiple underlying causes were identified, including congenital anomalies; respiratory, endocrine, cardiovascular, and neurological diseases; cancer; and external causes. Cosibling analyses suggested that the observed associations were not due to shared genetic or environmental factors in families. Interpretation: Preterm and early term birth should be recognised as chronic conditions that require long-term follow-up for adverse health sequelae in adulthood. Funding: National Heart, Lung, and Blood Institute at the National Institutes of Health.
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| 9. |
- Crump, Casey, et al.
(författare)
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Gestational Age at Birth and Mortality in Young Adulthood
- 2011
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Ingår i: JAMA: The Journal of the American Medical Association. - : American Medical Association (AMA). - 1538-3598. ; 306:11, s. 1233-1240
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Tidskriftsartikel (refereegranskat)abstract
- Context Preterm birth is the leading cause of infant mortality in developed countries, but the association between gestational age at birth and mortality in adulthood remains unknown. Objective To examine the association between gestational age at birth and mortality in young adulthood. Design, Setting, and Participants National cohort study of 674 820 individuals born as singletons in Sweden in 1973 through 1979 who survived to age 1 year, including 27 979 born preterm (gestational age <37 weeks), followed up to 2008 (ages 29-36 years). Main Outcome Measures All-cause and cause-specific mortality. Results A total of 7095 deaths occurred in 20.8 million person-years of follow-up. Among individuals still alive at the beginning of each age range, a strong inverse association was found between gestational age at birth and mortality in early childhood (ages 1-5 years: adjusted hazard ratio [aHR] for each additional week of gestation, 0.92; 95% CI, 0.89-0.94; P<.001), which disappeared in late childhood (ages 6-12 years: aHR, 0.99; 95% CI, 0.95-1.03; P=.61) and adolescence (ages 13-17 years: aHR, 0.99; 95% CI, 0.95-1.03; P=.64) and then reappeared in young adulthood (ages 18-36 years: aHR, 0.96; 95% CI, 0.94-0.97; P<.001). In young adulthood, mortality rates (per 1000 person-years) by gestational age at birth were 0.94 for 22 to 27 weeks, 0.86 for 28 to 33 weeks, 0.65 for 34 to 36 weeks, 0.46 for 37 to 42 weeks (full-term), and 0.54 for 43 or more weeks. Preterm birth was associated with increased mortality in young adulthood even among individuals born late preterm (34-36 weeks, aHR, 1.31; 95% CI, 1.13-1.50; P<.001), relative to those born full-term. In young adulthood, gestational age at birth had the strongest inverse association with mortality from congenital anomalies and respiratory, endocrine, and cardiovascular disorders and was not associated with mortality from neurological disorders, cancer, or injury. Conclusion After excluding earlier deaths, low gestational age at birth was independently associated with increased mortality in early childhood and young adulthood. JAMA. 2011;306(11):1233-1240 www.jama.com
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| 10. |
- Crump, Casey, et al.
(författare)
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Gestational Age at Birth and Mortality in Young Adulthood EDITORIAL COMMENT
- 2012
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Ingår i: Obstetrical and Gynecological Survey. - 0029-7828. ; 67:1, s. 12-13
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Preterm birth is associated with increased rates of neonatal and infant mortality. It has been hypothesized that gestational age at birth may also be associated with increased mortality rates in adulthood, but to date, no studies have demonstrated this relationship. This national cohort study investigated the association between gestational age at birth and mortality in young adulthood. Data obtained from the Swedish Birth Registry identified 678,528 individuals who were born as singletons between 1973 and 1979 and survived to age 1 year. Among this cohort, 674,820 were included in the final analysis. Of these, 27,979 (4.1%) born preterm (<37 weeks) were followed to age 29 to 36 years (up to 2008). The primary study outcome measures were all-cause and cause-specific mortality. Cox proportional hazards regression was used to estimate the association between gestational age at birth and mortality for 4 age categories: early childhood (age, 1-5 years), late childhood (age, 6-12 years), adolescence (age, 13-17 years), and young adulthood (age, 18-36 years). There were 7095 deaths reported in 20.8 million person-years of follow-up. A strong inverse association was found between gestational age at birth for 2 of the age categories and mortality among individuals still alive at the beginning of each age range. The adjusted hazard ratio [aHR] for each additional week of gestation in early childhood was 0.92 (95% confidence interval [CI], 0.89-0.94; P < 0.001). This inverse association disappeared in late childhood (aHR, 0.99; 95% CI, 0.95-1.03; P = 0.61) and adolescence (aHR, 0.99; 95% CI, 0.95-1.03; P = 0.64), and reappeared in young adulthood (aHR, 0.96; 95% CI, 0.94-0.97; P < 0.001). In young adulthood, the gestational age at birth was associated with mortality rates (per 1000 person-years) as follows: the aHR was 0.94 for 22 to 27 weeks, 0.86 for 28 to 33 weeks, 0.65 for 34 to 36 weeks, 0.46 for 37 to 42 weeks (full-term), and 0.54 for 43 or more weeks (P < 0.001 for all). Relative to individuals born full-term, preterm birth was associated with increased mortality in young adulthood even among individuals born late preterm (34-36 weeks); the aHR was 1.31, with a 95% CI of 1.13-1.50; P < 0.001). Moreover, gestational age at birth in young adulthood had the strongest inverse association with mortality from congenital anomalies, as well as respiratory, endocrine, and cardiovascular disorders, and it had no association with mortality from neurological disorders, cancer, or injury.
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| 11. |
- Crump, Casey, et al.
(författare)
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Gestational age at birth and risk of allergic rhinitis in young adulthood
- 2011
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Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier BV. - 1097-6825 .- 0091-6749. ; 127:5, s. 1173-1179
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous studies of the association between gestational age or birth weight and allergic rhinitis in later life have had various limitations, including the inability to estimate risk among subjects born extremely preterm or to examine specific contributions of gestational age and fetal growth. Objective: We sought to determine whether gestational age at birth independent of fetal growth is associated with allergic rhinitis medication prescription in a national cohort of young adults. Methods: We conducted a national cohort study of 630,090 infants born in Sweden from 1973 through 1979 including 27,953 born preterm (<37 weeks) and followed for prescription of nasal corticosteroids and oral antihistamines in 2005-2009 (age, 25.5-37.0 years). Medication data were obtained from all outpatient and inpatient pharmacies throughout Sweden. Results: The overall prevalence of nasal corticosteroid and oral antihistamine prescription was 16.3% and 16.8%, respectively, which is similar to the reported prevalence of allergic rhinitis in this population. Low gestational age at birth was associated with a decreased risk of nasal corticosteroid and oral antihistamine prescription in young adulthood after adjusting for fetal growth and other potential confounders. For subjects born extremely preterm (23-28 weeks), adjusted odds ratios were 0.70 (95% CI, 0.51-0.96) for nasal corticosteroid prescription and 0.45 (95% CI, 0.27-0.76) for both nasal corticosteroid and oral antihistamine prescription relative to those born at full term. Conclusion: These findings suggest that low gestational age at birth independent of fetal growth is associated with a decreased risk of allergic rhinitis in young adulthood, possibly because of a protective effect of earlier exposure to pathogens. (J Allergy Clin Immunol 2011;127:1173-9.)
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| 12. |
- Crump, Casey, et al.
(författare)
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Gestational Age at Birth and Risk of Gastric Acid-Related Disorders in Young Adulthood
- 2012
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Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797. ; 22:4, s. 233-238
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Preterm birth is associated with gastric acid-related disorders in infancy, but no investigators have examined this association beyond early childhood. We used antisecretory medication data to explore whether preterm birth is associated with gastric acid-related disorders in young adulthood. METHODS: We conducted a national cohort study of 626,811 individuals born in Sweden in 1973 to 1979, followed up for antisecretory (proton pump inhibitor and H2-receptor antagonist) medication prescriptions from all outpatient and inpatient pharmacies nationwide from 2005 to 2009 (ages 25.5-37.0 years). We excluded individuals with congenital anomalies, and examined potential confounding by other comorbidities identified on the basis of oral anti-inflammatory or corticosteroid medication prescription. RESULTS: Gestational age at birth was inversely associated with antisecretory medication prescription in young adulthood. Adjusted odds ratios for >= 1 antisecretory medication prescription/year were 3.38 (95% confidence interval [95% CI], 1.73-6.62) for individuals born at 22-27 weeks, 1.38 (95% CI, 1.19-1.60) for those born at 28-34 weeks, and 1.19 (95% CI, 1.06-1.32) for those born at 35-36 weeks, relative to those born full-term (37-42 weeks). Exclusion of individuals who were prescribed oral anti-inflammatory or corticosteroid medications (>= 1/year) had little effect on these results. CONCLUSIONS: These findings suggest that low gestational age at birth may be independently associated with an increased risk of gastric acid-related disorders in young adulthood. Ann Epidemiol 2012;22:233-238. (C) 2012 Elsevier Inc. All rights reserved.
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| 13. |
- Crump, Casey, et al.
(författare)
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Gestational age at birth and risk of testicular cancer
- 2012
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136. ; 131:2, s. 446-451
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Tidskriftsartikel (refereegranskat)abstract
- Most testicular germ cell tumors originate from carcinoma in situ cells in fetal life, possibly related to sex hormone imbalances in early pregnancy. Previous studies of association between gestational age at birth and testicular cancer have yielded discrepant results and have not examined extreme preterm birth. Our objective was to determine whether low gestational age at birth is independently associated with testicular cancer in later life. We conducted a national cohort study of 354,860 men born in Sweden in 19731979, including 19,214 born preterm (gestational age < 37 weeks) of whom 1,279 were born extremely preterm (2229 weeks), followed for testicular cancer incidence through 2008. A total of 767 testicular cancers (296 seminomas and 471 nonseminomatous germ cell tumors) were identified in 11.2 million person-years of follow-up. Extreme preterm birth was associated with an increased risk of testicular cancer (hazard ratio = 3.95; 95% confidence interval = 1.679.34) after adjusting for other perinatal factors, family history of testicular cancer and cryptorchidism. Only five cases (three seminomas and two nonseminomas) occurred among men born extremely preterm, limiting the precision of risk estimates. No association was found between later preterm birth, post-term birth or low or high fetal growth and testicular cancer. These findings suggest that extreme but not later preterm birth may be independently associated with testicular cancer in later life. They are based on a small number of cases and will need confirmation in other large cohorts. Elucidation of the key prenatal etiologic factors may potentially lead to preventive interventions in early life.
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| 14. |
- Crump, Casey, et al.
(författare)
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Interactive Effects of Aerobic Fitness, Strength, and Obesity on Mortality in Men
- 2017
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Ingår i: American Journal of Preventive Medicine. - : Elsevier BV. - 0749-3797. ; 52:3, s. 353-361
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Low aerobic fitness, low muscular strength, and obesity have been associated with premature mortality, but their interactive effects are unknown. This study examined interactions among these common, modifiable factors, to help inform more-effective preventive interventions. Methods: This national cohort study included all 1,547,478 military conscripts in Sweden during 1969-1997 (97%-98% of all men aged 18 years each year). Aerobic fitness, muscular strength, and BMI measurements were examined in relation to all-cause and cardiovascular mortality through 2012 (maximum age, 62 years). Data were collected/analyzed in 2015-2016. Results: Low aerobic fitness, low muscular strength, and obesity at age 18 years were independently associated with higher all-cause and cardiovascular mortality in adulthood. The combination of low aerobic fitness and muscular strength (lowest versus highest tertiles) was associated with twofold all-cause mortality (adjusted hazard ratio=2.01; 95% CI=1.93, 2.08;. p<0.001; mortality rates per 100,000 person years, 247.2 vs 73.8), and 2.6-fold cardiovascular mortality (2.63; 95% CI=2.38, 2.91;. p<0.001; 43.9 vs 8.3). These factors also had positive additive and multiplicative interactions in relation to all-cause mortality (their combined effect exceeded the sum or product of their separate effects;. p<0.001), and were associated with higher mortality even among men with normal BMI. Conclusions: Low aerobic fitness, low muscular strength, and obesity at age 18 years were associated with increased mortality in adulthood, with interactive effects between aerobic fitness and muscular strength. Preventive interventions should begin early in life and include both aerobic fitness and muscular strength, even among those with normal BMI.
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| 15. |
- Crump, Casey, et al.
(författare)
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Interactive effects of physical fitness and body mass index on risk of stroke : A national cohort study
- 2016
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Ingår i: International Journal of Stroke. - : SAGE Publications. - 1747-4949 .- 1747-4930. ; 11:6, s. 683-694
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: High body mass index (BMI) and low physical fitness are risk factors for stroke, but their interactive effects are unknown. Elucidation of interactions between these modifiable risk factors can help inform preventive interventions in susceptible subgroups.METHODS: National cohort study of all 1,547,294 military conscripts in Sweden during 1969-1997 (97-98% of all 18-year-old males). Standardized aerobic capacity, muscular strength, and body mass index measurements were examined in relation to stroke identified from inpatient and outpatient diagnoses through 2012 (maximum age 62 years).RESULTS: Sixteen thousand nine hundred seventy-nine men were diagnosed with stroke in 39.7 million person-years of follow-up. High body mass index, low aerobic fitness, and (less strongly) low muscular fitness were associated with higher risk of any stroke, ischemic stroke, and intracerebral hemorrhage, independently of family history and sociodemographic factors. High body mass index (overweight/obese vs. normal) and low aerobic capacity (lowest vs. highest tertile) had similar effect magnitudes, and their combination was associated with highest stroke risk (incidence rate ratio, 2.36; 95% CI, 2.14-2.60; P < 0.001). Aerobic capacity and muscular strength had a positive additive and multiplicative interaction (P < 0.001), indicating that low aerobic capacity accounted for more strokes among men with low compared with high muscular strength.CONCLUSIONS: High body mass index and low aerobic capacity in late adolescence are associated with increased risk of stroke in adulthood. Low aerobic capacity and low muscular strength also have a synergistic effect on stroke risk. These findings suggest that preventive interventions should include weight control and aerobic fitness early in life, and muscular fitness especially among those with low aerobic capacity.
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| 16. |
- Crump, Casey, et al.
(författare)
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Interactive Effects of Physical Fitness and Body Mass Index on the Risk of Hypertension.
- 2016
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Ingår i: JAMA Internal Medicine. - : American Medical Association (AMA). - 2168-6114 .- 2168-6106. ; 176:2, s. 210-216
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Tidskriftsartikel (refereegranskat)abstract
- High body mass index (BMI) and low physical fitness are risk factors for hypertension, but their interactive effects are unknown. Elucidation of interactions between these modifiable risk factors may help inform more effective interventions in susceptible subgroups.
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| 17. |
- Crump, Casey, et al.
(författare)
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Low stress resilience in late adolescence and risk of hypertension in adulthood.
- 2016
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Ingår i: Heart. - : BMJ. - 1355-6037 .- 1468-201X.
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Tidskriftsartikel (refereegranskat)abstract
- Greater blood pressure reactivity to psychological stress has been associated with higher risk of developing hypertension. We hypothesised that low stress resilience based on psychological assessment early in life is associated with hypertension in adulthood.
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| 18. |
- Crump, Casey, et al.
(författare)
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Mental disorders and vulnerability to homicidal death: Swedish nationwide cohort study
- 2013
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Ingår i: BMJ: British Medical Journal. - : BMJ. - 1756-1833. ; 346, s. 557-557
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Tidskriftsartikel (refereegranskat)abstract
- Objective To determine the risk of people with mental disorders being victims of homicide. Design National cohort study. Setting Sweden. Participants Entire adult population (n=7 253 516). Main outcome measures Homicidal death during eight years of follow-up (2001-08); hazard ratios for the association between mental disorders and homicidal death, with adjustment for sociodemographic confounders; potential modifying effect of comorbid substance use. Results 615 homicidal deaths occurred in 54.4 million person years of follow-up. Mortality rates due to homicide (per 100 000 person years) were 2.8 among people with mental disorders compared with 1.1 in the general population. After adjustment for sociodemographic confounders, any mental disorder was associated with a 4.9-fold (95% confidence interval 4.0 to 6.0) risk of homicidal death, relative to people without mental disorders. Strong associations were found irrespective of age, sex, or other sociodemographic characteristics. Although the risk of homicidal death was highest among people with substance use disorders (approximately ninefold), the risk was also increased among those with personality disorders (3.2-fold), depression (2.6-fold), anxiety disorders (2.2-fold), or schizophrenia (1.8-fold) and did not seem to be explained by comorbid substance use. Sociodemographic risk factors included male sex, being unmarried, and low socioeconomic status. Conclusions In this large cohort study, people with mental disorders, including those with substance use disorders, personality disorders, depression, anxiety disorders, or schizophrenia, had greatly increased risks of homicidal death. Interventions to reduce violent death among people with mental disorders should tackle victimisation and homicidal death in addition to suicide and accidents, which share common risk factors.
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| 19. |
- Crump, Casey, et al.
(författare)
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Neighborhood Deprivation and Psychiatric Medication Prescription: A Swedish National Multilevel Study
- 2011
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Ingår i: Annals of Epidemiology. - : Elsevier BV. - 1047-2797. ; 21:4, s. 231-237
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Previous studies of neighborhood deprivation and mental disorders have yielded mixed results, possibly because they were based on different substrata of the population. We conducted a national multilevel study to determine whether neighborhood deprivation is independently associated with psychiatric medication prescription in a national population. METHODS: Nationwide outpatient and inpatient psychiatric medication data were analyzed for all Swedish adults (N = 6,998,075) after 2.5 years of follow-up. Multilevel logistic regression was used to estimate the association between neighborhood deprivation (index of education, income, unemployment, and welfare assistance) and prescription of psychiatric medications (antipsychotics, antidepressants, anxiolytics, or hypnotics/sedatives), after adjusting for broadly measured individual-level sociodemographic characteristics. RESULTS: For each psychiatric medication class, a monotonic trend of increasing prescription was observed by increasing level of neighborhood deprivation. The strongest associations were found for antipsychotics and anxiolytics, with adjusted odds ratios of 1.40 (95% confidence interval [CI], 1.36-1.44) and 1.24 (95% CI, 1.22-1.27), respectively, comparing the highest-to the lowest-deprivation neighborhood quintiles. CONCLUSIONS: These findings suggest that neighborhood deprivation is associated with psychiatric medication prescription independent of individual-level sociodemographic characteristics. Further research is needed to elucidate the mechanisms by which neighborhood deprivation may affect mental health and to identify the most susceptible groups in the population. Ann Epidemiol 2011;21:231-237. (C) 2011 Elsevier Inc. All rights reserved.
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| 20. |
- Crump, Casey, et al.
(författare)
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Perinatal and Familial Risk Factors for Acute Lymphoblastic Leukemia in a Swedish National Cohort
- 2015
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Ingår i: Cancer. - : Wiley. - 1097-0142 .- 0008-543X. ; 121:7, s. 1040-1047
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDPerinatal factors including high birth weight have been found to be associated with acute lymphoblastic leukemia (ALL) in case-control studies. However, to the best of our knowledge, these findings have seldom been examined in large population-based cohort studies, and the specific contributions of gestational age and fetal growth remain unknown. METHODSThe authors conducted a national cohort study of 3,569,333 individuals without Down syndrome who were born in Sweden between 1973 and 2008 and followed for the incidence of ALL through 2010 (maximum age, 38 years) to examine perinatal and familial risk factors. RESULTSThere were 1960 ALL cases with 69.7 million person-years of follow-up. After adjusting for potential confounders, risk factors for ALL included high fetal growth (incidence rate ratio [IRR] per additional 1 standard deviation, 1.07; 95% confidence interval [95% CI], 1.02-1.11 [P =.002]; and IRR for large vs appropriate for gestational age, 1.22; 95% CI, 1.06-1.40 [P =.005]), first-degree family history of ALL (IRR, 7.41; 95% CI, 4.60-11.95 [P<.001]), male sex (IRR, 1.20; 95% CI, 1.10-1.31 [P<.001]), and parental country of birth (IRR for both parents born in Sweden vs other countries, 1.13; 95% CI, 1.00-1.27 [P =.045]). These risk factors did not appear to vary by patient age at the time of diagnosis of ALL. Gestational age at birth, season of birth, birth order, multiple birth, parental age, and parental education level were not found to be associated with ALL. CONCLUSIONSIn this large cohort study, high fetal growth was found to be associated with an increased risk of ALL in childhood through young adulthood, independent of gestational age at birth, suggesting that growth factor pathways may play an important long-term role in the etiology of ALL. Cancer 2015;121:1040-1047. (c) 2014 American Cancer Society. The authors conducted what, to their knowledge, is the largest population-based cohort study to date to examine perinatal and familial risk factors for acute lymphoblastic leukemia (ALL) among approximately 3.5 million individuals born in Sweden between 1973 and 2008. High fetal growth was found to be associated with an increased risk of ALL in childhood through young adulthood, independent of gestational age at birth, suggesting that growth factor pathways may play an important long-term role in the etiology of ALL.
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| 21. |
- Crump, Casey, et al.
(författare)
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Perinatal And Familial Risk Factors For Brain Tumors in Childhood Through Young Adulthood.
- 2015
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Ingår i: Cancer Research. - 1538-7445. ; 75:3, s. 576-583
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Tidskriftsartikel (refereegranskat)abstract
- Perinatal factors including high birth weight have been associated with childhood brain tumors in case-control studies. However, the specific contributions of gestational age and fetal growth remain unknown, and these issues have never been examined in large cohort studies with follow-up into adulthood. We conducted a national cohort study of 3,571,574 persons born in Sweden in 1973-2008, followed up for brain tumor incidence through 2010 (maximum age 38 years) to examine perinatal and familial risk factors. There were 2,809 brain tumors in 69.7 million person-years of follow-up. After adjusting for potential confounders, significant risk factors for brain tumors included high fetal growth (incidence rate ratio [IRR] per additional 1 standard deviation, 1.04; 95% CI, 1.01-1.08, P=0.02), first-degree family history of a brain tumor (IRR, 2.43; 95% CI, 1.86-3.18, P<0.001), parental country of birth (IRR for both parents born in Sweden vs. other countries, 1.21; 95% CI, 1.09-1.35, P<0.001), and high maternal education level (Ptrend=0.01). These risk factors did not vary by age at diagnosis. The association with high fetal growth appeared to involve pilocytic astrocytomas, but not other astrocytomas, medulloblastomas, or ependymomas. Gestational age at birth, birth order, multiple birth, and parental age were not associated with brain tumors. In this large cohort study, high fetal growth was associated with an increased risk of brain tumors (particularly pilocytic astrocytomas) independently of gestational age, not only in childhood but also into young adulthood, suggesting that growth factor pathways may play an important long-term role in the etiology of certain brain tumor subtypes.
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| 22. |
- Crump, Casey, et al.
(författare)
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Perinatal and Family Risk Factors for Hodgkin Lymphoma in Childhood Through Young Adulthood
- 2012
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 176:12, s. 1147-1158
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Tidskriftsartikel (refereegranskat)abstract
- The incidence of Hodgkin lymphoma has increased among adolescents and young adults in recent decades, but the relevant risk factors in early life are still unknown. A national cohort study was conducted of 3,571,574 individuals born in Sweden in 19732008 and followed up for Hodgkin lymphoma incidence through 2009, to examine perinatal and family risk factors for Hodgkin lymphoma in childhood through young adulthood (ages 037 years). There were 943 Hodgkin lymphoma cases identified in 66.3 million person-years of follow-up. High fetal growth was associated with an increased risk of Hodgkin lymphoma after adjustment for gestational age at birth and other potential confounders (P-trend 0.005). Family history of Hodgkin lymphoma in a sibling or parent also was strongly associated with an increased risk, with adjusted hazard ratios 8.83 (95 confidence interval: 3.67, 21.30) and 7.19 (95 confidence interval: 3.58, 14.44), respectively. No association was found between gestational age at birth, birth order, twinning, parental age, or parental education and Hodgkin lymphoma. These findings did not vary by age at Hodgkin lymphoma diagnosis. Similar associations were found for nodular sclerosis and mixed cellularity subtypes. These findings suggest that perinatal factors including possible growth factor pathways may contribute to the risk of Hodgkin lymphoma in childhood through young adulthood.
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| 23. |
- Crump, Casey, et al.
(författare)
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Perinatal risk factors for acute myeloid leukemia
- 2015
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 1573-7284 .- 0393-2990. ; 30:12, s. 1277-1285
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Tidskriftsartikel (refereegranskat)abstract
- Infectious etiologies have been hypothesized for acute leukemias because of their high incidence in early childhood, but have seldom been examined for acute myeloid leukemia (AML). We conducted the first large cohort study to examine perinatal factors including season of birth, a proxy for perinatal infectious exposures, and risk of AML in childhood through young adulthood. A national cohort of 3,569,333 persons without Down syndrome who were born in Sweden in 1973-2008 were followed up for AML incidence through 2010 (maximum age 38 years). There were 315 AML cases in 69.7 million person-years of follow-up. We found a sinusoidal pattern in AML risk by season of birth (P < 0.001), with peak risk among persons born in winter. Relative to persons born in summer (June-August), incidence rate ratios for AML were 1.72 (95 % CI 1.25-2.38; P = 0.001) for winter (December-February), 1.37 (95 % CI 0.99-1.90; P = 0.06) for spring (March-May), and 1.27 (95 % CI 0.90-1.80; P = 0.17) for fall (September-November). Other risk factors for AML included high fetal growth, high gestational age at birth, and low maternal education level. These findings did not vary by sex or age at diagnosis. Sex, birth order, parental age, and parental country of birth were not associated with AML. In this large cohort study, birth in winter was associated with increased risk of AML in childhood through young adulthood, possibly related to immunologic effects of early infectious exposures compared with summer birth. These findings warrant further investigation of the role of seasonally varying perinatal exposures in the etiology of AML.
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| 24. |
- Crump, Casey, et al.
(författare)
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Perinatal risk factors for Wilms tumor in a Swedish national cohort
- 2014
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 1573-7284 .- 0393-2990. ; 29:3, s. 191-197
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Tidskriftsartikel (refereegranskat)abstract
- Perinatal risk factors including high birth weight have been associated with Wilms tumor in case-control studies. However, these findings have seldom been examined in large cohort studies, and the specific contributions of gestational age at birth and fetal growth remain unknown. We conducted the largest population-based cohort study to date consisting of 3,571,574 persons born in Sweden in 1973-2008, followed up for Wilms tumor incidence through 2009 to examine perinatal risk factors. There were 443 Wilms tumor cases identified in 66.3 million person-years of follow-up. After adjusting for gestational age and other perinatal factors, high fetal growth was associated with increased risk of Wilms tumor among girls (hazard ratio per 1 standard deviation (SD), 1.36; 95 % CI 1.20-1.54; P < 0.001), but not boys (1.10; 95 % CI 0.97-1.25; P = 0.14) (P (interaction) = 0.02). Among girls, high fetal growth was associated with disease onset before age 5 years (odds ratio per 1 SD, 1.47; 95 % CI 1.28-1.69; P < 0.001), but not beyond (1.00; 95 % CI 0.76-1.31; P = 0.99). No clear associations were found for gestational age at birth or other perinatal factors. In this large cohort study, high fetal growth was associated with Wilms tumor before age 5 years among girls. These findings suggest that early-life growth factor pathways for Wilms tumor may be more common among girls than boys. Further elucidation of these mechanisms may reveal better targets for prevention or treatment of specific subtypes of Wilms tumor.
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| 25. |
- Crump, Casey, et al.
(författare)
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Physical fitness among swedish military conscripts and long-term risk for type 2 diabetes mellitus a cohort study
- 2016
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Ingår i: Annals of Internal Medicine. - 0003-4819. ; 164:9, s. 577-584
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early-life physical fitness has rarely been examined in relation to type 2 diabetes mellitus (DM) in adulthood because of the lengthy follow-up required. Elucidation of modifiable risk factors at young ages may help facilitate earlier and more effective interventions. Objective: To examine aerobic capacity and muscle strength at age 18 years in relation to risk for type 2 DM in adulthood. Design: National cohort study. Setting: Sweden. Participants: 1 534 425 military conscripts from 1969 to 1997 (97% to 98% of all men aged 18 years nationwide) without prior type 2 DM. Measurements: Aerobic capacity and muscle strength (measured in watts and newtons per kilogram of body weight, respectively) were examined in relation to type 2 DM identified from outpatient and inpatient diagnoses from 1987 to 2012 (maximum age, 62 years). Results: 34 008 men were diagnosed with type 2 DM in 39.4 million person-years of follow-up. Low aerobic capacity and muscle strength were independently associated with increased risk for type 2 DM. The absolute difference in cumulative incidence of type 2 DM between the lowest and highest tertiles of both aerobic capacity and strength was 0.22% at 20 years of follow-up (95% CI, 0.20% to 0.25%), 0.76% at 30 years (CI, 0.71% to 0.81%), and 3.97% at 40 years (CI, 3.87% to 4.06%). Overall, the combination of low aerobic capacity and muscle strength was associated with a 3-fold risk for type 2 DM(adjusted hazard ratio, 3.07 [CI, 2.88 to 3.27]; P <0.001), with a positive additive interaction (P <0.001). These associations were seen even among men with normal body mass index. Limitation: This cohort did not include women and did not measure physical fitness at older ages. Conclusion: In this large cohort of Swedish male military conscripts, low aerobic capacity and muscle strength at age 18 years were associated with increased long-term risk for type 2 DM, even among those with normal body mass index. Primary Funding Source: National Institutes of Health.
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| 26. |
- Crump, Casey, et al.
(författare)
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Preterm birth and risk of chronic kidney disease from childhood into mid-adulthood : National cohort study
- 2019
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Ingår i: BMJ (Online). - : BMJ. - 1756-1833 .- 0959-8138. ; 365
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the relation between preterm birth (gestational age <37 weeks) and risk of CKD from childhood into mid-adulthood. Design National cohort study. Setting Sweden. Participants 4 186 615 singleton live births in Sweden during 1973-2014. Exposures Gestational age at birth, identified from nationwide birth records in the Swedish birth registry. Main outcome measures CKD, identified from nationwide inpatient and outpatient diagnoses through 2015 (maximum age 43 years). Cox regression was used to examine gestational age at birth and risk of CKD while adjusting for potential confounders, and co-sibling analyses assessed the influence of unmeasured shared familial (genetic or environmental) factors. Results 4305 (0.1%) participants had a diagnosis of CKD during 87.0 million person years of follow-up. Preterm birth and extremely preterm birth (<28 weeks) were associated with nearly twofold and threefold risks of CKD, respectively, from birth into mid-adulthood (adjusted hazard ratio 1.94, 95%confidence interval 1.74 to 2.16; P<0.001; 3.01, 1.67 to 5.45; P<0.001). An increased risk was observed even among those born at early term (37-38 weeks) (1.30, 1.20 to 1.40; P<0.001). The association between preterm birth and CKD was strongest at ages 0-9 years (5.09, 4.11 to 6.31; P<0.001), then weakened but remained increased at ages 10-19 years (1.97, 1.57 to 2.49; P<0.001) and 20-43 years (1.34, 1.15 to 1.57; P<0.001). These associations affected both males and females and did not seem to be related to shared genetic or environmental factors in families. Conclusions Preterm and early term birth are strong risk factors for the development of CKD from childhood into mid-adulthood. People born prematurely need long term follow-up for monitoring and preventive actions to preserve renal function across the life course.
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| 27. |
- Crump, Casey, et al.
(författare)
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Prevalence of Survival Without Major Comorbidities Among Adults Born Prematurely
- 2019
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Ingår i: JAMA. - : American Medical Association (AMA). - 0098-7484. ; 322:16, s. 1580-1588
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Preterm birth has been associated with cardiometabolic, respiratory, and neuropsychiatric disorders in adulthood. However, the prevalence of survival without any major comorbidities is unknown. Objective: To determine the prevalence of survival without major comorbidities in adulthood among persons born preterm vs full-term. Design, Setting, and Participants: National cohort study of all 2 566 699 persons born in Sweden from January 1, 1973, through December 31, 1997, who had gestational age data and who were followed up for survival and comorbidities through December 31, 2015 (ages 18-43 years). Exposures: Gestational age at birth. Main Outcomes and Measures: Survival without major comorbidities among persons born extremely preterm (22-27 weeks), very preterm (28-33 weeks), late preterm (34-36 weeks), or early term (37-38 weeks), compared with full-term (39-41 weeks). Comorbidities were defined using the Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE) Comorbidity Index, which includes conditions that commonly manifest in adolescence or young adulthood, including neuropsychiatric disorders; and the Charlson Comorbidity Index (CCI), which includes major chronic disorders predictive of mortality in adulthood. Poisson regression was used to determine prevalence ratios and differences, adjusted for potential confounders. Results: In this study population, 48.6% were female, 5.8% were born preterm, and the median age at end of follow-up was 29.8 years (interquartile range, 12.6 years). Of all persons born preterm, 54.6% were alive with no AYA HOPE comorbidities at the end of follow-up. Further stratified, this prevalence was 22.3% for those born extremely preterm, 48.5% for very preterm, 58.0% for late preterm, 61.2% for early term, and 63.0% for full-term. These prevalences were significantly lower for earlier gestational ages vs full-term (eg, adjusted prevalence ratios: extremely preterm, 0.35 [95% CI, 0.33 to 0.36; P < .001]; all preterm, 0.86 [95% CI, 0.85 to 0.86; P < .001]; adjusted prevalence differences: extremely preterm, -0.41 [95% CI, -0.42 to -0.40; P < .001]; all preterm, -0.09 [95% CI, -0.09 to -0.09; P < .001]). Using the CCI, the corresponding prevalences were 73.1% (all preterm), 32.5% (extremely preterm), 66.4% (very preterm), 77.1% (late preterm), 80.4% (early term), and 81.8% (full-term) (adjusted prevalence ratios: extremely preterm, 0.39 [95% CI, 0.38 to 0.41; P < .001]; all preterm, 0.89 [95% CI, 0.89 to 0.89; P < .001]; adjusted prevalence differences: extremely preterm, -0.50 [95% CI, -0.51 to -0.49; P < .001]; all preterm, -0.09 [95% CI, -0.09 to -0.09; P < .001]). Conclusions and Relevance: Among persons born preterm in Sweden between 1973 and 1997, the majority survived to early to mid-adulthood without major comorbidities. However, outcomes were worse for those born extremely preterm.
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| 28. |
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| 29. |
- Crump, Casey, et al.
(författare)
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Risk of Asthma in Young Adults Who Were Born Preterm: A Swedish National Cohort Study
- 2011
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 1098-4275 .- 0031-4005. ; 127:4, s. 913-920
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Preterm birth is associated with asthma-like symptoms in childhood and possibly in adolescence, but the longer-term risk of asthma is unknown and increasingly relevant as larger numbers of these individuals enter adulthood. Our objective was to evaluate whether those who were born preterm are more likely to be prescribed asthma medications in young adulthood than those who were born term. PATIENTS AND METHODS: We conducted a national cohort study of all singleton infants born in Sweden from 1973 through 1979 (n = 622 616), followed to ages 25.5 to 35.0 years to determine whether asthma medications were prescribed in 2005-2007. Asthma medication data were obtained from all outpatient and inpatient pharmacies throughout Sweden. To improve the positive predictive value for asthma, the outcome was defined as prescription of (1) both a beta-2 agonist inhalant and a glucocorticoid inhalant or (2) a combination inhalant containing a beta-2 agonist and other drugs for obstructive airway diseases. RESULTS: Young adults who were born extremely preterm (23-27 weeks' gestation) were 2.4 times more likely (adjusted 95% CI: 1.41-4.06) to be prescribed asthma medications than those who were born term. No association was found between later preterm birth (28-32 or 33-36 weeks' gestation) and asthma medications in young adulthood. CONCLUSIONS: This is the first study with sufficient statistical power to evaluate the risk of asthma beyond adolescence in individuals who were born extremely preterm. The results suggest that extreme preterm birth (23-27 weeks' gestation), but not later preterm birth, is associated with an increased risk of asthma at least into young adulthood. Pediatrics 2011; 127: e913-e920
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| 30. |
- Crump, Casey, et al.
(författare)
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Risk of Diabetes Among Young Adults Born Preterm in Sweden
- 2011
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Ingår i: Diabetes Care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 34:5, s. 1109-1113
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE-Previous studies have suggested that preterm birth is associated with diabetes later in life. These studies have shown inconsistent results for late preterm births and have had various limitations, including the inability to evaluate diabetic outpatients or to estimate risk across the full range of gestational ages. Our objective was to determine whether preterm birth is associated with diabetes medication prescription in a national cohort of young adults. RESEARCH DESIGN AND METHODS-This was a national cohort study of 630,090 infants born in Sweden from 1973 through 1979 (including 27,953 born preterm, gestational age < 37 weeks), followed for diabetes medication prescription in 2005-2009 (ages 25.5-37.0 years). Medication data were obtained from all outpatient and inpatient pharmacies throughout Sweden. RESULTS-Individuals born preterm, including those born late preterm (gestational age 35-36 weeks), had modestly increased odds ratios (ORs) for diabetes medication prescription relative to those born full term, after adjusting for fetal growth and other potential confounders. Insulin and/or oral diabetes medications were prescribed to 1.5% of individuals born preterm compared with 1.2% of those born full term (adjusted OR 1.13 [95% CI 1.02-1.26]). Insulin without oral diabetes medications was prescribed to 1.0% of individuals born preterm compared with 0.8% of those born full term (1.22 [1.08-1.39]). CONCLUSIONS-Preterm birth, including late preterm birth, is associated with a modestly increased risk of diabetes in young Swedish adults. These findings have important public health implications given the increasing number of preterm births and the large disease burden of diabetes, particularly when diagnosed in young adulthood.
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| 31. |
- Crump, Casey, et al.
(författare)
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Risk of Hypertension Among Young Adults Who Were Born Preterm: A Swedish National Study of 636,000 Births
- 2011
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 173:7, s. 797-803
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have reported an association between preterm birth and elevated blood pressure in adolescence and young adulthood. These studies were based on single-day blood pressure measurements and had limited ability to estimate risk of hypertension measured over a longer period and across the full range of gestational ages. The authors conducted a national cohort study of all infants born in Sweden from 1973 through 1979 (n = 636,552), including 28,220 born preterm (< 37 weeks), followed to ages 25.5-37.0 years to determine whether individuals born preterm were more likely to be prescribed antihypertensive medications in 2005-2009 than those born full term. Antihypertensive medication data were obtained from all outpatient and inpatient pharmacies throughout Sweden. Young adults who were born preterm had an increased relative rate of antihypertensive medication prescription that increased monotonically by earlier gestational age and that was independent of fetal growth. The adjusted odds ratio for >= 1 antihypertensive medications/year ranged from 1.25 (95% confidence interval: 1.12, 1.39) for those born near term (35-36 weeks) to 2.51 (95% confidence interval: 1.11, 5.68) for those born extremely preterm (23-27 weeks) relative to those born full term. These findings suggest that preterm birth is strongly associated with hypertension in young adulthood, including an increased risk among those born near term.
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| 32. |
- Crump, Casey, et al.
(författare)
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Stress resilience and subsequent risk of type 2 diabetes in 1.5 million young men.
- 2016
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 59:4, s. 728-733
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Tidskriftsartikel (refereegranskat)abstract
- Psychosocial stress in adulthood is associated with a higher risk of type 2 diabetes, possibly mediated by behavioural and physiological factors. However, it is unknown whether low stress resilience earlier in life is related to subsequent development of type 2 diabetes. We examined whether low stress resilience in late adolescence is associated with an increased risk of type 2 diabetes in adulthood.
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| 33. |
- Sundquist, Jan, et al.
(författare)
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School Achievement and Risk of Eating Disorders in a Swedish National Cohort.
- 2016
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Ingår i: Journal of the American Academy of Child and Adolescent Psychiatry. - : Elsevier BV. - 0890-8567. ; 55:1, s. 1-46
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Tidskriftsartikel (refereegranskat)abstract
- High achievement in school has been associated with increased risk of eating disorders, including anorexia nervosa (AN) and bulimia nervosa (BN), but causality of these relationships is unclear. We sought to examine the association between school achievement and AN or BN in a national cohort and to determine the possible contribution of familial confounding using a co-relative design.
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