| 1. |
- Rostila, Mikael, et al.
(författare)
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The Forgotten Griever : A Nationwide Follow-up Study of Mortality Subsequent to the Death of a Sibling
- 2012
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 176:4, s. 338-346
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Tidskriftsartikel (refereegranskat)abstract
- Previous findings have suggested that the loss of a family member is associated with mortality among bereaved family members. The least-studied familial relationship in the bereavement literature is that of siblings, although loss of a sibling may also involve health consequences. The authors conducted a follow-up study based on data from the Swedish total population register, covering the period 1981–2002. Using Cox regression, mortality risk ratios for bereaved and nonbereaved persons aged 18–69 years were estimated. All-cause mortality and cause-specific mortality (unnatural causes, natural causes, cardiovascular disease, cancer, suicide, accidents, and all other causes) were examined. In men, the mortality risk for bereaved persons versus nonbereaved persons was 1.26 (95% confidence interval: 1.22, 1.30), and in women it was 1.33 (95% confidence interval: 1.28, 1.39). An elevated mortality risk associated with a sibling's death was found in all age groups studied, but the association was generally stronger at younger ages and could be observed predominantly after more than 1 year of follow-up. There was also an increased mortality risk if the sibling had died from a discordant main cause, which may strengthen the possibility that the association observed is not due to confounding alone.
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| 2. |
- Seblova, Dominika, et al.
(författare)
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Does Prolonged Education Causally Affect Dementia Risk When Adult Socioeconomic Status Is Not Altered? A Swedish Natural Experiment in 1.3 Million Individuals
- 2021
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 190:5, s. 817-826
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Tidskriftsartikel (refereegranskat)abstract
- Intervening on modifiable risk factors to prevent dementia is of key importance, since progress-modifying treatments are not currently available. Education is inversely associated with dementia risk, but causality and mechanistic pathways remain unclear. We aimed to examine the causality of this relationship in Sweden using, as a natural experiment, data on a compulsory schooling reform that extended primary education by 1 year for 70% of the population between 1936 and 1949. The reform introduced substantial exogenous variation in education that was unrelated to pupils' characteristics. We followed 18 birth cohorts (n = 1,341,842) from 1985 to 2016 (up to ages 79-96 years) for a dementia diagnosis in the National Inpatient and Cause of Death registers and fitted Cox survival models with stratified baseline hazards at the school-district level, chronological age as the time scale, and cohort indicators. Analyses indicated very small or negligible causal effects of education on dementia risk (main hazard ratio = 1.01, 95% confidence interval: 0.98, 1.04). Multiple sensitivity checks considering only compliers, the pre-/post- design, differences in health-care-seeking behavior, and the impact of exposure misclassification left the results essentially unaltered. The reform had limited effects on further adult socioeconomic outcomes, such as income. Our findings suggest that without mediation through adult socioeconomic position, education cannot be uncritically considered a modifiable risk factor for dementia.
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| 3. |
- Ahrén-Moonga, Jennie, et al.
(författare)
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Association of Higher Parental and Grandparental Education and Higher School Grades With Risk of Hospitalization for Eating Disorders in Females : The Uppsala Birth Cohort Multigenerational Study
- 2009
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 170:5, s. 566-575
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Tidskriftsartikel (refereegranskat)abstract
- Eating disorders are a leading cause of disease burden amongyoung women. This study investigated associations of socialcharacteristics of parents and grandparents, sibling position,and school performance with incidence of eating disorders. Theauthors studied Swedish females born in 1952–1989 (n =13,376), third-generation descendants of a cohort born in Uppsalain 1915–1929. Data on grandparental and parental socialcharacteristics, sibling position, school grades, hospitalizations,emigrations, and deaths were obtained by register linkages.Associations with incidence of hospitalization for eating disorderswere studied with multivariable Cox regression, adjusted forage and study period. Overall incidence of hospitalization foreating disorders was 32.0/100,000 person-years. Women with morehighly educated parents and maternal grandparents were at higherrisk (hazard ratio for maternal grandmother with higher educationrelative to elementary education = 6.5, 95% confidence interval:2.2, 19.3, adjusted for parental education). Independent offamily social characteristics, women with the highest schoolgrades had a higher risk of eating disorders (hazard ratio =7.7, 95% confidence interval: 2.5, 24.1 for high compared withlow grades in Swedish, adjusted for parental education). Thus,higher parental and grandparental education and higher schoolgrades may increase risk of hospitalization for eating disordersin female offspring, possibly because of high internal and externaldemands.
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| 4. |
- Goisis, Alice, et al.
(författare)
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Advanced Maternal Age and the Risk of Low Birth Weight and Preterm Delivery : a Within-Family Analysis Using Finnish Population Registers
- 2017
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 186:11, s. 1219-1226
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Tidskriftsartikel (refereegranskat)abstract
- Advanced maternal age at birth is considered a major risk factor for birth outcomes. It is unclear to what extent this association is confounded by maternal characteristics. To test whether advanced maternal age at birth independently increases the risk of low birth weight (< 2,500 g) and preterm birth (< 37 weeks' gestation), we compared between-family models (children born to different mothers at different ages) with within-family models (children born to the same mother at different ages). The latter procedure reduces confounding by unobserved parental characteristics that are shared by siblings. We used Finnish population registers, including 124,098 children born during 1987-2000. When compared with maternal ages 25-29 years in between-family models, maternal ages of 35-39 years and a parts per thousand40 years were associated with percentage increases of 1.1 points (95% confidence intervals: 0.8, 1.4) and 2.2 points (95% confidence intervals: 1.4, 2.9), respectively, in the probability of low birth weight. The associations are similar for the risk of preterm delivery. In within-family models, the relationship between advanced maternal age and low birth weight or preterm birth is statistically and substantively negligible. In Finland, advanced maternal age is not independently associated with the risk of low birth weight or preterm delivery among mothers who have had at least 2 live births.
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| 5. |
- Rostila, Mikael, et al.
(författare)
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Birth Order and Suicide in Adulthood : Evidence From Swedish Population Data
- 2014
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 179:12, s. 1450-1457
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Tidskriftsartikel (refereegranskat)abstract
- Each year, almost 1 million people die from suicide, which is among the leading causes of death in young people. We studied how birth order was associated with suicide and other main causes of death. A follow-up study based on the Swedish population register was conducted for sibling groups born from 1932 to 1980 who were observed during the period 1981-2002. Focus was on the within-family variation in suicide risk, meaning that we studied sibling groups that consisted of 2 or more children in which at least 1 died from suicide. These family-fixed effects analyses revealed that each increase in birth order was related to an 18% higher suicide risk (95% confidence interval (CI): 1.14, 1.23, P = 0.000). The association was slightly lower among sibling groups born in 1932-1955 (hazard ratio = 1.13, 95% CI: 1.06, 1.21, P = 0.000) than among those born in 1967-1980 (hazard ratio = 1.24, 95% CI: 0.97, 1.57, P = 0.080). Further analyses suggested that the association between birth order and suicide was only modestly influenced by sex, birth spacing, size of the sibling group, own socioeconomic position, own marital status, and socioeconomic rank within the sibling group. Causes of death other than suicide and other external causes were not associated with birth order.
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| 6. |
- Ahlborg, Gunnar, 1948, et al.
(författare)
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Tobacco smoke exposure and pregnancy outcome among working women. A prospective study at prenatal care centers in Orebro County, Sweden
- 1991
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Ingår i: Am J Epidemiol. - 0002-9262. ; 133:4, s. 338-47
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Tidskriftsartikel (refereegranskat)abstract
- Among 4,687 women undergoing prenatal care in Orebro County, Sweden, from October 1980 to June 1983, 678 nonsmokers reported passive exposure to tobacco smoke. Of these women, 267 had been passively exposed at work, and the risk ratio (RR) for intrauterine death (spontaneous abortion or stillbirth) among these pregnancies was increased to 1.53 (95% confidence interval (CI) 0.98-2.38) compared with pregnancies of unexposed working women. This could not be explained by age, previous spontaneous abortion, educational level, planning of pregnancy, or alcohol use. The effect was confined to first-trimester fetal loss (adjusted RR = 2.16, 95% CI 1.23-3.81), while active smoking was associated with intrauterine death after the first trimester. Passive exposure in the workplace was weakly associated with preterm birth (less than 37 weeks) but not with low birth weight (less than 2,500 g) among full-term livebirths. Active smoking clearly increased the risk of both of these outcomes. However, passive exposure in the home only did not seem to affect pregnancy outcome. The lack of quantitative exposure data points to the need for more research before passive exposure to tobacco smoke can be regarded as an established hazard to fetal development and survival.
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| 7. |
- Bengtsson, Tommy, et al.
(författare)
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Social Class and Excess Mortality in Sweden During the 1918 Influenza Pandemic
- 2018
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 187:12, s. 2568-2576
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Tidskriftsartikel (refereegranskat)abstract
- There is no consensus in the literature about the role of socioeconomic factors on influenza mortality during the 1918 pandemic. While some scholars have found that social factors were important, others have not. In this study, we analyzed differences in excess mortality by social class in Sweden during the 1918 pandemic. We analyzed individual-level mortality of the entire population aged 30–59, by combining information from death records with census data on occupation. Social class was measured by an occupation-based class scheme. Excess mortality during the pandemic was measured as mortality relative to the same month the year before. Social class differences in mortality were modeled using a complementary log-log model, adjusting for potential confounding at the family, the residential (urban/rural) and the county levels. Our findings indicated notable class differences in excess mortality but no perfect class gradient. Class differences were somewhat larger for men than for women.
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| 8. |
- Carlson, Elwood, et al.
(författare)
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Low-weight Neonatal Survival Paradox in the Czech Republic
- 1999
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Ingår i: American Journal of Epidemiology. - 0002-9262 .- 1476-6256. ; 149:5, s. 447-453
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Tidskriftsartikel (refereegranskat)abstract
- Analysis of vital statistics for the Czech Republic between 1986 and 1993, including 3,254 infant deaths from350,978 first births to married and single women who conceived at ages 18-29 years, revealed a neonatalsurvival advantage for low-weight infants born to disadvantaged (single, less educated) women, particularly fordeaths from congenital anomalies. This advantage largely disappeared after the neonatal period. The samepatterns have been observed for low-weight infants born to black women in the United States. Since the CzechRepublic had an ethnically homogenous population, virtually universal prenatal care, and uniform institutionalconditions for delivery, Czech results must be attributed to social rather than to biologic or medicalcircumstances. This strengthens the contention that in the United States, the black neonatal survival paradoxmay be due as much to race-related social stigmatization and consequent disadvantage as to any hypothesizedhereditary influences on birth-weight-specific survival. Am J Epidemiol 1999; 149:447-53.
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| 9. |
- Jayasekara, Harindra, et al.
(författare)
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Alcohol Consumption Over Time and Risk of Death : A Systematic Review and Meta-Analysis
- 2014
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 179:9, s. 1049-1059
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Forskningsöversikt (refereegranskat)abstract
- The results from the few cohort studies that have measured usual alcohol consumption over time have not been summarized. We therefore conducted a systematic review and meta-analysis to quantify mortality risk. Pertinent studies were identified by searching the Medline, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, and Scopus databases through August 2012 using broad search criteria. Studies reporting relative mortality risks for quantitatively defined categories of alcohol consumption over time were eligible. Nine cohort studies published during 1991-2010 (comprising 62,950 participants and 10,490 deaths) met the inclusion criteria. For men, there was weak evidence of lower mortality risk with low levels of alcohol intake over time but higher mortality risk for those with intakes over 40 g/day compared with abstainers using a random-effects model (P for nonlinearity = 0.02). The pooled relative risks were 0.90 (95% confidence interval: 0.81, 0.99) for 1-29 g/day, 1.19 (95% confidence interval: 0.89, 1.58) for 30-59 g/day, and 1.52 (95% confidence interval: 0.78, 2.98) for 60 or more g/day compared with abstention. There was moderate between-study heterogeneity but no evidence of publication bias. Studies including women were extremely scarce. Our findings include a curvilinear association between drinking over time and mortality risk for men overall and widespread disparity in methods used to capture exposure and report results.
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