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- Bonamy, Anna-Karin E., et al.
(författare)
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Preterm Birth and Later Retinal Detachment
- 2013
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Ingår i: Ophthalmology. - : Elsevier BV. - 0161-6420 .- 1549-4713. ; 120:11, s. 2278-2285
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Ophthalmologic complications after preterm birth are common. Small studies show an association between retinopathy of prematurity and later retinal detachment. There are no population-based studies of preterm birth and risk of retinal detachment, which was the objective of the current investigation.Design: Nationwide Swedish cohort study based on population registries.Participants: Of 3 423 697 subjects born in Sweden, 1 271 725 were born between 1973 and 1986 (i.e., before the national screening program for retinopathy of prematurity started), and 2 151 972 were born between 1987 and 2008. The participants were followed up from 1 year of age until 2009.Methods: Unadjusted and adjusted hazard ratios (HRs) for retinal detachment were calculated using Cox proportional hazards regression.Main Outcome Measures: Incident retinal detachment, as defined by a diagnosis in the Swedish Patient Register (both inpatient and hospital-based outpatient data).Results: During follow-up (median follow-up, 17.4 years), 1749 subjects were diagnosed with retinal detachment. Among the 188 852 subjects born prematurely (i.e., at < 37 weeks of gestation), there were 124 cases of retinal detachment, of which 42 occurred in the 20 470 subjects born before 32 weeks of gestation. Compared with subjects born at term (37-41 weeks), the adjusted HR for retinal detachment after extremely preterm birth (< 28 weeks of gestation) was 19.2 (95% confidence interval [CI], 10.3-35.8) for births between 1973 and 1986 and 8.95 (95% CI, 3.98-20.1) for births between 1987 and 2008. The corresponding HRs in subjects born very prematurely (28-31 weeks) were 4.32 (95% CI, 2.70-6.90) and 2.80 (95% CI, 1.38-5.69), respectively. Moderately preterm birth (32-36 weeks) was not associated with an increased risk of retinal detachment.Conclusions: Birth before 32 weeks of gestation is associated with a substantially increased relative risk of retinal detachment. These findings may have implications for ophthalmologic follow-up of children and adults born very prematurely.
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| 4. |
- Shemer, E. Wikström, et al.
(författare)
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Intrahepatic cholestasis of pregnancy and associated adverse pregnancy and fetal outcomes : a 12-year population-based cohort study
- 2013
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley-Blackwell. - 1470-0328 .- 1471-0528. ; 120:6, s. 717-723
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine the risk for adverse pregnancy and fetal outcomes in intrahepatic cholestasis of pregnancy (ICP).Design: Population-based cohort study.Setting: Swedish Medical Birth Register (MBR) 19972009.Population: A total of 1213668 singleton deliveries.Methods: Linkage of Hospital Discharge Register for exposure (ICP; n=5477) with MBR for covariates.Main outcome measures: Gestational diabetes, pre-eclampsia, prematurity, and stillbirth.Results: Intrahepatic cholestasis (ICP) was diagnosed in 0.320.58% of all pregnancies, with an increasing trend until 2005 (P<0.0001). Compared with women who did not have ICP, women with ICP were more likely to have gestational diabetes (adjusted odds ratio, aOR, 2.81; 95% CI 2.323.41) and pre-eclampsia (aOR 2.62, 95% CI 2.322.78). Women with ICP were also more likely to have spontaneous (aOR 1.60, 95% CI 1.471.93) and iatrogenic (aOR 5.95, 95% CI 5.236.60) preterm delivery, with increased rates of induction of labour (aOR 11.76, 95% CI 11.0411.62). However, this actively managed cohort of ICP cases was not at increased risk of stillbirth (aOR 0.92, 95% CI 0.521.62). Infants in ICP deliveries were more likely to have a low (<7) 5-minute Apgar score (aOR 1.45, 95% CI 1.141.85) and be large for gestational age at birth (aOR 2.27, 95% CI 2.022.55).Conclusions: Over time, a greater proportion of Swedish pregnant women have received a diagnosis of ICP, probably because of an increased awareness of the disorder. Our data confirm an increased risk of preterm delivery, but not of stillbirth, in actively managed ICP. The high rates of gestational diabetes and pre-eclampsia are new findings, and need to be considered in the management of ICP pregnancies.
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- Skalkidou, Alkistis, 1977-, et al.
(författare)
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O-058 46thCongress of the International Society of Paediatric Oncology (SIOP) 2014
- 2014
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Ingår i: Pediatric Blood & Cancer. - : John Wiley & Sons. - 1545-5009 .- 1545-5017. ; 61:S2, s. S121-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives:Birth weight has been explored as a risk factor for several types of childhood (0-14 years) cancer. This nationwide Swedish cohort study aims to evaluate the associationbetween crude and adjusted characteristics of fetal growth (birth weight, length, headcircumference, ponderal index, small-SGA, appropriate-AGA and large for gestational age-LGA) and non-Hodgkin lymphoma (NHL) risk.Methods:All 3,444,136 singleton live births were included, among whom 515 incident NHLcases aged 0-14 years were diagnosed in 1973-2007, as identified through linkage with theSwedish Cancer Register. Proportional hazards models were used to estimate the HazardRatio (HR) and 95% confidence intervals (95% CI) of NHL. The core multivariable modelincluded infant sex, maternal education and maternal age at delivery, birth order of the indexchild (1þchild) and gestational age, the latter omitted in the analyses with SGA, AGA, LGAvariables, as appropriate.Results:Male sex was associated with a doubled NHL risk (HR¼2.00, 95% CI: 1.66-2.41).LGA birth weight, but not birth weightper se, was associated with an 80% increase in NHLrisk (HR¼1.83, 95%CI: 1.20-2.79). In the subgroup analyses by sex, the latter associationwas confined particularly to females (HR¼3.37, 95% CI: 1.90-5.97). Other growth variableswere not consistently associated with NHL risk, prossibly due to smaller variation ormeasurement errors.Conclusions:Fetal macrosomy seems to represent a considerable risk factor for childhoodNHL, whereas its effect may differ by gender. An approach to assess the association solelyusing crude birth weight, as a proxy, seems inadequate, given that more elaborate LGA indicesmay portray accelerated intrauterine growth as a more meaningful component. Future studiesshould aim at disentangling the physiological mechanisms underlying the relevance of sex-specific associations.
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