998Use of antibiotics in pregnancy and ear infection trajectories in children

Abstract Background Exposure to antibiotics during pregnancy can exercise a teratogenic effect on foetuses. Middle ear infection represents the most common cause of physician visits for sick children. Its patterns may be partly explained by antibiotics use during pregnancy. This study aimed to investigate the associations between antibiotics use in pregnancy and ear infection trajectories. Methods Design & Participants: Birth cohort assessed biennially from 2004 to 2014 spanning ages 0-1 to 10-11 years in the Longitudinal Study of Australian Children. Measures: Mothers-reported antibiotics use in pregnancy; Parent-reported ongoing ear infections (waves 1 to 6). Analysis: Latent class models identified ear infection trajectories. Multinomial logistic regression quantified associations between antibiotics use in pregnancy and ear infection trajectories. Results of the 4500 included children (mean age at baseline wave 0.7 years, 51.3% boys), 10.4% had parent-reported antibiotics use in pregnancy. Four probability trajectories of ear infection emerged: “consistently low” (86.2%), “moderate to low” (5.6%), “low to moderate” (6.7%), and “consistently high” (1.4%). Antibiotics use in pregnancy was associated children following “moderate to low” (OR 1.8, 95% CI 1.3 to 2.6) and “consistently high” (OR 2.1, 95% CI 1.1 to 4.0) trajectories. Conclusions Antibiotics use in pregnancy increases the risk of persistent and early ear infections in the offspring, implying that reducing unnecessary antibiotics use during pregnancy may prevent childhood ear infections. Additional information on classes and timing of antibiotics exposure at different stages of pregnancy and ear infections resistance could further explain this relationship and inform interventional studies. Key messages Antibiotics use in pregnancy is associated with an increased risk of persistent and early ear infections in the offspring.

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Association of in Utero Antibiotic Exposure With Childhood Ear Infection Trajectories: A National Birth Cohort Study

10.21203/rs.3.rs-83291/v1 ◽

2020 ◽

Author(s):

Yanhong Jessika Hu ◽

Jing Wang ◽

Joseph Irvin Harwell ◽

Melissa Wake

Keyword(s):

Birth Cohort ◽

Latent Class ◽

Multinomial Logistic Regression ◽

Antibiotic Use ◽

In Utero ◽

Latent Class Models ◽

Antibiotic Exposure ◽

Ear Infection ◽

Increased Risk ◽

In Pregnancy

Abstract BackgroundMost prescribed medicines during pregnancy are antibiotics, with unknown effects on a foetus and on the infant’s acquired microbiome. This study investigates associations between in utero antibiotic exposure and ear infection trajectories over the first decade of life, hypothesising effects on early or persistent, rather than later-developing, ear infections.MethodsDesign & Participants: The Longitudinal Study of Australian Children (LSAC) birth cohort recruited a nationally-representative sample of 5107 infants in 2004. Measures: Mothers reported antibiotic use in pregnancy when a child was 3-21 months old (wave 1), and ongoing problems with ear infection every 2 years spanning ages 0-1 to 10-11 years (waves 1 to 6). Analysis: Latent class models identified ear infection trajectories, and univariable and multivariable multinomial logistic regression determined odds of adverse trajectories by antibiotic exposure. Results4500 (88.1% of original sample) children contributed (mean baseline age 0.7 years; 51.3% boys); 10.4% of mothers reported antibiotic use in pregnancy. Four probability trajectories for ear infection emerged: “consistently low” (86.2%), “moderate to low” (5.6%), “low to moderate” (6.7%) and “consistently high” (1.4%). Antibiotic use in pregnancy was associated with children following “consistently high” (aOR 2.06, 95% CI 1.09 to 3.91, p=0.03) and “moderate to low” (aOR 1.78, 95% CI 1.25 to 2.53, p=0.001) trajectories.ConclusionsAntibiotic use in pregnancy is associated with an increased risk of persistent and early childhood ear infections. This highlights the wisdom of cautious antibiotic use during pregnancy, and the need for study of potential mechanisms underlying these associations.

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Birth weight for gestational age and the risk of asthma in childhood and adolescence: a retrospective cohort study

Archives of Disease in Childhood ◽

10.1136/archdischild-2018-315059 ◽

2018 ◽

Vol 104 (2) ◽

pp. 179-183 ◽

Cited By ~ 4

Author(s):

Jillian H Carter ◽

Christy G Woolcott ◽

Lihui Liu ◽

Stefan Kuhle

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Retrospective Cohort ◽

Cox Proportional Hazards ◽

Childhood And Adolescence ◽

Term Infants ◽

Physician Visits ◽

Smoking In Pregnancy ◽

Increased Risk ◽

In Pregnancy

ObjectiveTo examine the association between birth weight for gestational age and asthma in childhood and adolescence while controlling for potential confounders and considering smoking as an effect modifier.MethodsA retrospective cohort of all singleton term births in Nova Scotia, Canada, between 1989 and 1993 was identified in the provincial perinatal database and followed through 2014 by linking with administrative health data. The outcome, asthma, was defined as having one hospitalisation or two physician visits with an International Classification of Diseases code for asthma in a 2-year period. Birth weight was categorised as small (SGA), large (LGA) or appropriate (AGA) for gestational age. Multivariable-adjusted Cox proportional hazards models were used to examine the association between the birth weight for gestational age and asthma and to test for effect modification by maternal smoking in pregnancy.ResultsOf the 40 724 cohort children, 10.5% and 11.7% were born SGA and LGA, respectively, and the risk of developing asthma to age 18 years was 30.2%. The adjusted HRs for SGA and LGA (relative to AGA) and asthma were 1.07 (95% CI 1.02 to 1.14) and 0.96 (95% CI 0.91 to 1.02), respectively. Relative to AGA children born to non-smoking mothers, SGA children were not at increased risk of asthma (HR 1.02), whereas both AGA and SGA children born to smoking mothers were at significantly increased risk (HR 1.14 and 1.29, respectively).ConclusionsOur findings suggest that SGA in term infants is not associated with asthma in childhood in the absence of smoking in pregnancy.

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A Note on the Connection Between Knowledge Structures and Latent Class Models

Methodology ◽

10.1027/1614-2241/a000023 ◽

2011 ◽

Vol 7 (2) ◽

pp. 63-67 ◽

Cited By ~ 8

Author(s):

Ali Ünlü

Keyword(s):

Latent Variable ◽

Probabilistic Models ◽

Latent Class ◽

Latent Class Models ◽

Knowledge Structures ◽

Future Research ◽

Comprehensive Overview ◽

Additional Information ◽

Constructing Knowledge ◽

Class Models

Schrepp (2005) points out and builds upon the connection between knowledge space theory (KST) and latent class analysis (LCA) to propose a method for constructing knowledge structures from data. Candidate knowledge structures are generated, they are considered as restricted latent class models and fitted to the data, and the BIC is used to choose among them. This article adds additional information about the relationship between KST and LCA. It gives a more comprehensive overview of the literature and the probabilistic models that are at the interface of KST and LCA. KST and LCA are also compared with regard to parameter estimation and model testing methodologies applied in their fields. This article concludes with an overview of KST-related publications addressing the outlined connection and presents further remarks about possible future research arising from a connection of KST to other latent variable modeling approaches.

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Integrating Sample Similarities into Latent Class Analysis: A Tree-Structured Shrinkage Approach

10.1101/2021.01.25.428033 ◽

2021 ◽

Author(s):

Mengbing Li ◽

Daniel E. Park ◽

Maliha Aziz ◽

Cindy M Liu ◽

Lance B. Price ◽

...

Keyword(s):

Latent Class ◽

Latent Class Models ◽

Accurate Estimation ◽

Individual Level ◽

Additional Information ◽

Posterior Inference ◽

Similarity Information ◽

The Given ◽

Class Models ◽

Additional Sample

SummaryThis paper is concerned with using multivariate binary observations to estimate the proportions of unobserved classes with scientific meanings. We focus on the setting where additional information about sample similarities is available and represented by a rooted weighted tree. Every leaf in the given tree contains multiple independent samples. Shorter distances over the tree between the leaves indicate higher similarity. We propose a novel data integrative extension to classical latent class models (LCMs) with tree-structured shrinkage. The proposed approach enables 1) borrowing of information across leaves, 2) estimating data-driven leaf groups with distinct vectors of class proportions, and 3) individual-level probabilistic class assignment given the observed multivariate binary measurements. We derive and implement a scalable posterior inference algorithm in a variational Bayes framework. Extensive simulations show more accurate estimation of class proportions than alternatives that suboptimally use the additional sample similarity information. A zoonotic infectious disease application is used to illustrate the proposed approach. The paper concludes by a brief discussion on model limitations and extensions.

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Abstract 093: Salt-sensitivity, Salt-resistance, and Incidence of Hypertension

Hypertension ◽

10.1161/hyp.68.suppl_1.093 ◽

2016 ◽

Vol 68 (suppl_1) ◽

Author(s):

Jiang He ◽

Jing Chen ◽

Jianfeng Huang ◽

Jichun Chen ◽

Hua He ◽

...

Keyword(s):

Latent Class ◽

Dietary Intervention ◽

Salt Resistance ◽

Salt Sensitivity ◽

Latent Class Models ◽

Dietary Sodium ◽

Incident Hypertension ◽

High Sodium ◽

Low Sodium ◽

Increased Risk

It is well known that blood pressure (BP) responses to dietary sodium intake vary among individuals (salt-sensitivity and salt-resistance). However, it is unknown whether salt-sensitivity and salt-resistance predict the risk of hypertension. We conducted a dietary sodium intervention study among 1,906 Han Chinese in 2003-05 and followed the study participants in 2008-09 and 2011-12. The dietary intervention included a 7-day low-sodium feeding (51.3 mmol/day) and a 7-day high-sodium feeding (307.8 mmol/day). Three BP measurements were obtained during each of the 3 days of baseline observation and on days 5, 6, and 7 of each intervention period. We used latent class models to identify subgroups that share a similar underlying trajectory in BP responses to sodium intervention. Over an average of 7.4 years of follow-up, we identified 514 incident hypertension cases. The mean (standard deviation) change in systolic BP during low-sodium and high-sodium interventions according to salt-sensitive and -resistant groups are shown in the following table. In addition, age, sex, and baseline BP-adjusted and multiple-adjusted odds ratios (95% CI) of incident hypertension are shown in the following table. These data indicate that high responses or non-responses to dietary sodium intervention are related to the risk of hypertension. Furthermore, this is the first prospective cohort study to indicate that individuals with either salt-sensitivity or salt-resistance are at an increased risk for hypertension and should be targeted for dietary intervention.

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The Effects of Pre-Pregnancy Body Mass Index and Gestational Weight Gain on the Risk of Preeclampsia at a Tertiary Referral Hospital, Northern Tanzania

10.21203/rs.3.rs-114602/v1 ◽

2020 ◽

Author(s):

Nelago Tukondjeni Amagulu ◽

Bariki Mchome ◽

Julius Pius Alloyce ◽

Kingsly Tobi ◽

Eusebius Maro

Keyword(s):

Weight Gain ◽

Gestational Weight Gain ◽

Multinomial Logistic Regression ◽

Normal Weight ◽

Excessive Weight Gain ◽

Gestational Weight ◽

Excessive Weight ◽

Northern Tanzania ◽

Increased Risk ◽

In Pregnancy

Abstract Background: Pre/eclampsia and other hypertensive disorders of pregnancy contributed to 18% of the maternal mortality reported in Northern Tanzanian. There is increasing prevalence of obesity in Tanzania which is related to excessive weight gain in pregnancy. Both high BMI and excessive gestation weight gain are identified to increase risk of PE and subtypes, however this is still inconclusive and little is known about the joint effect of pre-pregnancy BMI and GWG on risk of PE and its subtypes in Africa. We evaluated the independent and joint effects of pre-pregnancy BMI and GWG on the risk of pre-eclampsia and its subtypes among women who delivered at Kilimanjaro Christian Medical Center (KCMC) from October 2018 to May 2019, Northern Tanzania.Methods: We performed a retrospective birth cohort study from October 2018 to May 2019 at KCMC, Tanzania. Pre-pregnancy BMI was categorized using WHO categories into Underweight (˂ 18.5kg/m²), Normal weight (18.5-24.9kg/m²), Overweight (25-29.9kg/m²) and Obese (≥ 30kg/m²). Gestational Weight Gain (GWG) was categorized using the 2009 Institute of Medicine (IOM) guidelines into Inadequate, Adequate and Excessive weight gain in pregnancy. Multinomial logistic regression analysis was used to adjust for confounders using relative risk, 95% confidence interval for the risk ratios (RR) that did not cross 1 and p<0.05 were regarded statistically significant.Results: Among the 1309 women analysed, 5.3% were Underweight, 51.1% Normal weight, 26.9% Overweight and 16.7% were Obese. About 43.5% had excessive GWG. Women with PE were 9.5%. Both obesity and excessive GWG independently increased risk of PE with adjusted RR=2.42, 95%CI: 1.48-3.96 and RR=1.77, 95%CI: 1.16-2.69 when compared to normal BMI and adequate GWG respectively. Jointly, Obesity and Excessive GWG had the highest risk of PE (ARR=4.95, 95%CI: 2.21-11.10). The increased risk was similar for Mild PE (MPE), Severe PE or eclampsia (SP/E) and Late Onset PE (LOPE). No association was found for Early Onset PE (EOPE).Conclusion: Pre-pregnancy Obesity and Excessive GWG independently and jointly increases risk for PE and the risk varies by PE subtype.

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Latent variable mixture modelling of treated drug misuse in Ireland

Advances in Methodology and Statistics ◽

10.51936/yafa1077 ◽

2004 ◽

Vol 1 (1) ◽

pp. 213-223

Author(s):

Paul Cahill ◽

Brendan Bunting

Keyword(s):

Latent Class ◽

Multinomial Logistic Regression ◽

Relative Size ◽

Latent Class Models ◽

Drug Misuse ◽

Parameter Estimates ◽

Republic Of Ireland ◽

Research Division ◽

The Republic ◽

Drug Problems

This study provides analyses and profiles of illegal drug usage in the Republic of Ireland. Two questions are addressed: a) can individuals be grouped into homogeneous classes based upon their type of drug consumption, and b) how do these classes differ in terms of other key background variables? The data reported in this study is from the National Drug Treatment Reporting System database in the Republic of Ireland. All analyses were carried out in collaboration with the Drug Misuse Research Division (the Irish REITOX / EMCDDA focal point). This database contains information on all 6994 individuals who received treatment for drug problems in the Republic of Ireland during 2000. The analysis was conducted in four steps. First, a single class model was examined in order to establish the respective probability associated with each drug type. Second, a series of unconditional latent class models was examined. This was done to establish the optimal number of latent classes required to describe the data, and to establish the relative size of each latent class. From this analysis the conditional probabilities for each individual, within a given class, were examined for typical profiles. Third, a series of conditional models was then examined in terms of key predictors (age and early school leavers). This analysis was conducted using MPlus 2.13. In the final stage of the research, the parameter estimates obtained from the multinomial logistic regression model (that was previously used to express the probability of an individual being in a given latent class, conditional on a series of covariates) were graphically modelled within EXCEL and the respective functions described. The results from this analysis will be described in terms of a) the profiling of typical serious drug misuse in Ireland, b) the clustering of drug types and, c) the respective importance of key background variables. The various profiles obtained are discussed in terms of health care strategies in Ireland.

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566Ear infection trajectories and academic, behavioural and quality of life outcomes: A population-based longitudinal study

International Journal of Epidemiology ◽

10.1093/ije/dyab168.693 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Jing Wang ◽

Jon Quach ◽

Valerie Sung ◽

Peter Carew ◽

Melissa Wake

Keyword(s):

Quality Of Life ◽

Longitudinal Study ◽

Standardized Test ◽

Latent Class Models ◽

Adverse Outcomes ◽

Effect Sizes ◽

Common Disease ◽

Ear Infection ◽

Ear Infections

Abstract Background Middle ear infection is a common disease in childhood. Outcomes might vary by its patterns and persistence over time. We aimed to investigate 1) typical trajectories of ear infections throughout childhood and 2) their associations with child outcomes. Methods Design & Participants: Two parallel cohorts assessed biennially from 2004 to 2014 spanning ages 0-1 to 10-11 years (B cohort, n = 3721) and ages 4-5 to 14-15 years (K cohort, n = 3489) in the Longitudinal Study of Australian Children. Ear infection: Parent-reported ongoing ear infections (B: waves 1-6; K: waves 1, 2, 4, 5). Outcomes (wave 6): National academic standardized test, teacher-reported learning, parent and teacher-reported behaviour and self-reported quality of life. Analysis: Latent class models identified ear infection trajectories. Linear regression quantified associations between trajectories and outcomes. Results Four probability trajectories of ear infection emerged in both cohorts: “consistently low” (B 86.2%, K 87.0%), “moderate to low” (5.5%, 9.7%), “low to moderate” (7.0%, 1.5%), and “consistently high” (1.4%, 1.8%). In K cohort, the “consistently high” group had the worst outcomes (effect sizes 0.2-0.8 SDs), with effect sizes largest for psychosocial and language outcomes. “Moderate to low” and “low to moderate” groups showed no to marginal academic associations, but behaviour and quality of life were 0.2-0.3 SDs poorer than the “consistently low” group. Similar but attenuated associations were seen in B cohort. Conclusions Sizable adverse outcomes followed the consistently high trajectory, suggesting cumulative rather than age-dependent burden. Additional information about comorbidities, predictors and objective presence of ear infections could inform causal relationships. Key messages Parent-reported ear infections follow four childhood trajectories (consistently low, moderate to low, low to moderate, consistently high). Sizable adverse outcomes follow the consistently high trajectory.

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Developmental Measurement of Mental Attention

International Journal of Behavioral Development ◽

10.1177/016502549401700110 ◽

1994 ◽

Vol 17 (1) ◽

pp. 161-200 ◽

Cited By ~ 66

Author(s):

Juan Pascual-Leone ◽

Raymond Baillargeon

Keyword(s):

Latent Class ◽

Latent Class Models ◽

Categorical Data Analysis ◽

Test Items ◽

Mental Demand ◽

Mental Attention ◽

Constructivist Model ◽

Discrete Manner ◽

Analysis System ◽

Data Analysis System

A dialectical constructivist model of mental attention ("effort") and of working memory is briefly presented, and used to explicate subjects' processing in misleading test items. We illustrate with task analyses of the Figural Intersections Test (FIT). We semantically derive a set of 10 Theoretical Structural Predictions (TSP) that stipulate relations between mental attentional resources (mental-power: Mp) and the systematically varied mental demand of items (mental-demand: Md), as they jointly codetermine probable performance (conditional probabilities of passing and failing). These predictions are evaluated on first approximation using a known family of ordered Latent Class models, all probabilistic versions of Guttman's unidimensional scale. Parameters of these models were estimated using the Categorical Data Analysis System of Eliason (1990). Main results are: (1) Data fit Lazarsfeld's latent-distance model, providing initial support for our 10 predictions; (2) The M-power of children (latent Mp-classes) when assessed behaviourally may increase with age in a discrete manner, and have the potential to generate interval scales of measurement; (3) In the light of our results what statisticians often consider "error of measurement" appears (in part) to be signal, not noise: The organismic signal of misleading (Y-) processes that in their dialectical (trade-off) interaction with success-producing (X-) processes generate performance.

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Endometriosis and Risk of Adverse Pregnancy Outcome: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10040667 ◽

2021 ◽

Vol 10 (4) ◽

pp. 667

Author(s):

Kjerstine Breintoft ◽

Regitze Pinnerup ◽

Tine Brink Henriksen ◽

Dorte Rytter ◽

Niels Uldbjerg ◽

...

Keyword(s):

Preterm Birth ◽

Cesarean Section ◽

Placental Abruption ◽

Gestational Hypertension ◽

Adverse Pregnancy Outcome ◽

Placenta Previa ◽

Meta Analysis ◽

Increased Risk ◽

Spontaneous Hemoperitoneum ◽

In Pregnancy

Background: This systematic review and meta-analysis summarizes the evidence for the association between endometriosis and adverse pregnancy outcome, including gestational hypertension, pre-eclampsia, low birth weight, and small for gestational age, preterm birth, placenta previa, placental abruption, cesarean section, stillbirth, postpartum hemorrhage, spontaneous hemoperitoneum in pregnancy, and spontaneous bowel perforation in pregnancy. Methods: We performed the literature review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), by searches in PubMed and EMBASE, until 1 November 2020 (PROSPERO ID CRD42020213999). We included peer-reviewed observational cohort studies and case-control studies and scored them according to the Newcastle–Ottawa Scale, to assess the risk of bias and confounding. Results: 39 studies were included. Women with endometriosis had an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth, compared to women without endometriosis. These results remained unchanged in sub-analyses, including studies on spontaneous pregnancies only. Spontaneous hemoperitoneum in pregnancy and bowel perforation seemed to be associated with endometriosis; however, the studies were few and did not meet the inclusion criteria. Conclusions: The literature shows that endometriosis is associated with an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth.

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