scholarly journals Term cesarean breech delivery in the first pregnancy is associated with an increased risk for maternal and neonatal morbidity in the subsequent delivery: a national cohort study

2020 ◽  
Vol 302 (1) ◽  
pp. 85-91
Author(s):  
Georg Macharey ◽  
Anna Toijonen ◽  
Pia Hinnenberg ◽  
Mika Gissler ◽  
Seppo Heinonen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Neonatal Morbidity ◽  
Breech Delivery ◽  
Increased Risk ◽  
National Cohort

scholarly journals Risk of hypertension into adulthood in persons born prematurely: a national cohort study

2019 ◽  
Vol 41 (16) ◽  
pp. 1542-1550 ◽  
Author(s):  
Casey Crump ◽  
Jan Sundquist ◽  
Kristina Sundquist
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Environmental Factors ◽  
Gestational Age ◽  
Large Population ◽  
Increased Risk ◽  
Extremely Preterm ◽  
National Cohort ◽  
Gestational Age At Birth ◽  
Age At Birth

Abstract Aims Preterm birth has been associated with elevated blood pressure early in life; however, hypertension risks from childhood into adulthood remain unclear. We conducted a large population-based study to examine gestational age at birth in relation to hypertension risks from childhood into adulthood. Methods and results A national cohort study was conducted of all 4 193 069 singleton live births in Sweden during 1973–2014, who were followed up for hypertension identified from nationwide inpatient and outpatient (specialty and primary care) diagnoses from any health care encounters through 2015 (maximum age 43 years; median 22.5). Cox regression was used to examine gestational age at birth in relation to hypertension risk while adjusting for other perinatal and maternal factors, and co-sibling analyses assessed the potential influence of unmeasured shared familial (genetic and/or environmental) factors. In 86.8 million person-years of follow-up, 62 424 (1.5%) persons were identified with hypertension (median age 29.8 years at diagnosis). Adjusted hazard ratios for new-onset hypertension at ages 18–29 years associated with preterm (<37 weeks) and extremely preterm (22–27 weeks) birth were 1.28 [95% confidence interval (CI), 1.21–1.36] and 2.45 (1.82–3.31), respectively, and at ages 30–43 years were 1.25 (1.18–1.31) and 1.68 (1.12–2.53), respectively, compared with full-term birth (39–41 weeks). These associations affected males and females similarly and appeared substantially related to shared genetic or environmental factors in families. Conclusions In this large national cohort, preterm birth was associated with increased risk of hypertension into early adulthood. Persons born prematurely may need early preventive evaluation and long-term monitoring for the development of hypertension.

Increased risk of site-specific cancer in people with type 2 diabetes: a national cohort study

2019 ◽  
Author(s):  
Linkeviciute-Ulinskiene Donata ◽  
Patasius Ausvydas ◽  
Zabuliene Lina ◽  
Smailyte Giedre
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Site Specific ◽  
Increased Risk ◽  
Specific Cancer ◽  
National Cohort

Tonsillectomy associated with an increased risk of autoimmune diseases: A national cohort study

2016 ◽  
Vol 72 ◽  
pp. 1-7 ◽  
Author(s):  
Jianguang Ji ◽  
Jan Sundquist ◽  
Kristina Sundquist
Keyword(s):  
Cohort Study ◽  
Autoimmune Diseases ◽  
Increased Risk ◽  
National Cohort

scholarly journals Proton-pump inhibitors do not influence clinical outcomes in patients with Staphylococcus aureus bacteremia

2019 ◽  
Vol 12 ◽  
pp. 175628481983427 ◽  
Author(s):  
Aisling R. Caffrey ◽  
Tristan T. Timbrook ◽  
Syed Raza Ali ◽  
Victor Nizet ◽  
George Sakoulas
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Clinical Outcomes ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
De Novo ◽  
Culture Collection ◽  
Staphylococcus Aureus Bacteremia ◽  
Increased Risk ◽  
National Cohort

Background: Proton-pump inhibitors (PPIs) are commonly used in clinical practice for gastric acid suppression. However, these agents have also been associated with certain negative clinical outcomes. We evaluated the real-world effects of incident PPI use on clinical outcomes in patients with Staphylococcus aureus bacteremia. Methods: This retrospective cohort study included patients admitted to Veterans Affairs hospitals with positive S. aureus blood cultures collected between 2002 and 2013 that received appropriate antibiotics within 48 hours of culture collection. Clinical outcomes among three PPI exposure groups, each compared to nonusers, were assessed with propensity-score-matched Cox proportional-hazard regression models: pretreated PPI users initiating therapy in the 30 days prior to culture and either (a) continuing PPI therapy after culture, or (b) not continuing after culture, and (c) de novo users initiating at culture. Results: Clinical outcomes, including inpatient mortality, intensive care discharge, 30-day mortality, 30-day readmission, and 30-day Clostridium difficile infection (CDI) were similar among PPI users and nonusers. Though length of stay was longer in pretreated, continuing PPI users [time-to-discharge hazard ratio (HR) 0.78, 95% confidence interval (CI) 0.65–0.93], 14-day mortality was significantly lower than in nonusers (HR 0.66, 95% CI 0.50–0.87). Conclusions: In our large national cohort study, PPIs were not associated with an increased risk of negative clinical outcomes, including mortality and CDI, in patients with S. aureus bacteremia.

scholarly journals Type 1 diabetes in children born after assisted reproductive technology: a register-based national cohort study

2020 ◽  
Vol 35 (1) ◽  
pp. 221-231 ◽  
Author(s):  
E Norrman ◽  
M Petzold ◽  
T D Clausen ◽  
A-K Henningsen ◽  
S Opdahl ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cohort Study ◽  
Assisted Reproductive Technology ◽  
Embryo Transfer ◽  
Reproductive Technology ◽  
Frozen Embryo Transfer ◽  
Increased Risk ◽  
Subgroup Analyses ◽  
National Cohort

References STUDY QUESTION Do children born after assisted reproductive technology (ART) have an increased risk of developing type 1 diabetes? SUMMARY ANSWER Children born after ART were found to have an increased risk of type 1 diabetes in the unadjusted analysis, while after adjustment this association was only significant in children born after frozen embryo transfer. WHAT IS KNOWN ALREADY? Some studies raise concerns as to whether fertility treatments may influence long-term morbidity in children born after ART. Elevated blood pressure and altered glucose metabolism have been found after ART in a few studies. STUDY DESIGN, SIZE, DURATION A register-based national cohort study that included all children born in Sweden between 1985 and 2015—in total, 3 138 540 children—was carried out. PARTICIPANTS/MATERIAL, SETTING, METHODS The study was population-based and all live-born singleton children born after ART (n = 47 938) or spontaneous conception (SC) (n = 3 090 602) were included. The ART cohort comprised 36 727 children born after fresh embryo transfer and 11 211 children born after frozen embryo transfer. Several national registries were used together with data from Statistics Sweden. MAIN RESULTS AND THE ROLE OF CHANCE In total, 202 children born after ART and 17 916 children born after SC developed type 1 diabetes, corresponding to 43.4 and 35.5 per 100 000 person-years at risk (hazard ratio [HR] 1.23; 95% confidence interval [CI], 1.07 to 1.42). Mean follow-up was 9.7 (SD 6.4) years for ART children and 16.3 (SD 9.2) years for SC children. After adjustment for calendar year of birth, HR for type 1 diabetes was 1.13; 95% CI, 0.98–1.30. After further adjustment for sex, maternal age, country of birth, educational level, smoking and parental diabetes, HR was 1.07; 95% CI, 0.93–1.23. In subgroup analyses, an association was found between frozen embryo transfer and type 1 diabetes (adjusted HR 1.52; 95% CI, 1.08–2.14 and 1.41; 95% CI, 1.05–1.89 for frozen versus fresh and frozen versus SC, respectively). When comparing intracytoplasmic sperm injection to in vitro fertilization, no difference was found (adjusted HR 1.08; 95% CI, 0.77–1.51). LIMITATIONS, REASONS FOR CAUTION Limitations were the missing data and residual confounding caused by unknown confounders. Furthermore, the control group consisted of all children not conceived by ART and not non-ART children from subfertile mothers. The study was also performed in only singletons and not in the total ART population. WIDER IMPLICATIONS OF THE FINDINGS Type 1 diabetes is a serious disease, affecting human life in several ways, including risk of serious complications, reduced life span and a life-long treatment. Our results are generally reassuring, showing no increase in diabetes in ART children compared to children born after SC after adjustment for relevant confounders. The observation of an association between children born after frozen embryo transfer and type 1 diabetes, although based on subgroup analyses with a limited number of children and modest in size, is however a reason for concern. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by Nordforsk 71450, the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement 70940, and the Hjalmar Svensson Foundation. The authors have no competing interests. TRIAL REGISTRATION NUMBER ISRCTN 11780826.

National cohort study of reproductive risk factors for rheumatoid arthritis in Denmark: a role for hyperemesis, gestational hypertension and pre-eclampsia?

2009 ◽  
Vol 69 (2) ◽  
pp. 358-363 ◽  
Author(s):  
K T Jørgensen ◽  
B V Pedersen ◽  
S Jacobsen ◽  
R J Biggar ◽  
M Frisch
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Gestational Hypertension ◽  
Reproductive Factors ◽  
First Child ◽  
Increased Risk ◽  
Fetal Microchimerism ◽  
National Cohort ◽  
National Register Data ◽  
History Of

Objectives:While reproductive factors might plausibly be involved in the aetiology of rheumatoid arthritis (RA), the female predominance remains unexplained. A study was undertaken to address the possible impact of live births, pregnancy losses and pregnancy complications on the subsequent risk of RA in a nationwide cohort study.Methods:National register data were used to link reproductive histories and later RA hospitalisations in a cohort of 4.4 million Danes. As a measure of relative risk associated with different reproductive histories, ratios of first inpatient RA hospitalisation rates (RRs) were used with 95% confidence intervals (CIs) obtained by Poisson regression analysis.Results:Overall, 7017 women and 3041 men were admitted to hospital with RA in 1977–2004 (88.8 million person-years). The risk of RA was inversely associated with age at birth of first child in both women and men (p for trend <0.001). Overall, nulliparity and a history of pregnancy loss were not associated with RA risk but, compared with one-child mothers, women with two (RR 0.84; 95% CI 0.78 to 0.90) or three (RR 0.83; 95% CI 0.77 to 0.91) children were at reduced risk. The risk of RA was increased in women with a history of hyperemesis (RR 1.70; 95% CI 1.06 to 2.54), gestational hypertension (RR 1.49; 95% CI 1.06 to 2.02) or pre-eclampsia (RR 1.42; 95% CI 1.08 to 1.84).Conclusions:One-child mothers and young parents are at increased risk of RA later in life, possibly due to socioeconomic factors. The novel finding of a significantly increased risk of RA in women whose pregnancies were complicated by hyperemesis, gestational hypertension or pre-eclampsia might reflect reduced immune adaptability to pregnancy in women disposed to RA or a role of fetal microchimerism in the aetiology of RA.

scholarly journals Quantifying the association between ethnicity and COVID-19 mortality: a national cohort study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045286
Author(s):  
Hajira Dambha-Miller ◽  
Pui San Tan ◽  
Defne Saatci ◽  
Ashley Kieran Clift ◽  
Francesco Zaccardi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Minority Groups ◽  
Population Based ◽  
Cox Models ◽  
Explanatory Factors ◽  
Increased Risk ◽  
National Cohort ◽  
Ethnic Subgroups ◽  
Scientific Meetings ◽  
Care Database

IntroductionRecent evidence suggests that ethnic minority groups are disproportionately at increased risk of hospitalisation and death from SARS-CoV-2 infection. Population-based evidence on potential explanatory factors across minority groups and within subgroups is lacking. This study aims to quantify the association between ethnicity and the risk of hospitalisation and mortality due to COVID-19.Methods and analysisThis is a retrospective cohort study of adults registered across a representative and anonymised national primary care database (QResearch) that includes data on 10 million people in England. Sociodemographic, deprivation, clinical and domicile characteristics will be summarised and compared across ethnic subgroups (categorised as per 2011 census). Cox models will be used to calculate HR for hospitalisation and COVID-19 mortality associated with ethnic group. Potential confounding and explanatory factors (such as demographic, socioeconomic and clinical) will be adjusted for within regression models. The percentage contribution of distinct risk factor classes to the excess risks seen in ethnic groups/subgroups will be calculated.Ethics and disseminationThe study has undergone ethics review in accordance with the QResearch agreement (reference OX102). Findings will be disseminated through peer-reviewed manuscripts, presentations at scientific meetings and conferences with national and international stakeholders.

scholarly journals Risk of New Primary Cancer in Patients with Posterior Uveal Melanoma: A National Cohort Study

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 284
Author(s):  
Mette Bagger ◽  
Vanna Albieri ◽  
Tine Gadegaard Hindso ◽  
Karin Wadt ◽  
Steffen Heegaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Uveal Melanoma ◽  
Population Based ◽  
Control Group ◽  
Cancer Type ◽  
Primary Cancer ◽  
Increased Risk ◽  
Specific Cancer ◽  
National Cohort ◽  
Cancer Types

Background: Studies on the risk of new primary cancer in patients with posterior uveal melanoma (UM) have produced conflicting results, and the role of socioeconomic status (SES) is unknown. The purpose of this population-based matched cohort study was to determine the risk of new primary cancer following the diagnosis of posterior UM. Methods: 2179 patients with posterior UM 1968–2016 and 22,717 matched controls without cancer were included. Incidence and time-dependent hazard ratio (HR) of new primary cancer were described, and the effect of SES was emphasized in a sub-cohort. Results: The incidence of new primary cancer was increased in patients with posterior UM, rate ratio (RR) 1.21 (95% CI: 1.08; 1.35), but the specific cancer types did not differ compared to the controls. The rate of new primary cancer following the diagnosis of posterior UM was significantly increased 2–5 years (HR 1.49 (95% CI: 1.23; 1.80)) and 11–15 years (HR: 1.49 (95% CI: 1.12; 1.99)), and adjusting for SES did not change the rate (HR 1.35 (95% CI:1.20; 1.55)). Conclusions: Patients with posterior UM have an increased risk of new primary cancer independent of SES. No difference in incidence of specific cancer type was observed compared to the control group.

scholarly journals Increased Risk of Autoimmune Disorders in 21-Hydroxylase Deficiency: A Swedish Population-Based National Cohort Study

2019 ◽  
Author(s):  
Henrik Falhammar ◽  
Louise Frisén ◽  
Angelica Linden Hirschberg ◽  
Agneta Nordenskjöld ◽  
Catarina Almqvist ◽  
...  
Keyword(s):  
Cohort Study ◽  
Population Based ◽  
Autoimmune Disorders ◽  
Hydroxylase Deficiency ◽  
Swedish Population ◽  
Increased Risk ◽  
National Cohort ◽  
21 Hydroxylase Deficiency
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