scholarly journals Origins of disparities in preventable child mortality in England and Sweden: a birth cohort study

2019 ◽  
Vol 105 (1) ◽  
pp. 53-61 ◽  
Author(s):  
Ania Zylbersztejn ◽  
Ruth Gilbert ◽  
Anders Hjern ◽  
Pia Hardelid
Keyword(s):  
Cohort Study ◽  
Socioeconomic Factors ◽  
Birth Cohort ◽  
Child Mortality ◽  
Outcome Measures ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Birth Cohort Study ◽  
Unexpected Death ◽  
Birth Characteristics

ObjectiveTo compare mortality in children aged <5 years from two causes amenable to healthcare prevention in England and Sweden: respiratory tract infection (RTI) and sudden unexpected death in infancy (SUDI).DesignBirth cohort study using linked administrative health databases from England and Sweden.Setting and participantsSingleton live births between 2003 and 2012 in England and Sweden, followed up from age 31 days until the fifth birthday, death or 31 December 2013.Main outcome measuresThe main outcome measures were HR for RTI-related mortality at 31–364 days and at 1–4 years and SUDI mortality at 31–364 days in England versus Sweden estimated using Cox proportional hazards models. We calculated unadjusted HRs and HRs adjusted for birth characteristics (gestational age, birth weight, sex and congenital anomalies) and socioeconomic factors (maternal age and socioeconomic status).ResultsThe English cohort comprised 3 928 483 births, 768 RTI-related deaths at 31–364 days, 691 RTI-related deaths at 1–4 years and 1166 SUDIs; the corresponding figures for the Swedish cohort were 1 012 682, 131, 118 and 189. At 31–364 days, unadjusted HR for RTI-related death in England versus Sweden was 1.52 (95% CI 1.26 to 1.82). After adjusting for birth characteristics, the HR reduced to 1.16 (95% CI 0.96 to 1.40) and for socioeconomic factors to 1.11 (95% CI 0.92 to 1.34). At 1–4 years, unadjusted HR was 1.58 (95% CI 1.30 to 1.92) and decreased to 1.32 (95% CI 1.09 to 1.61) after adjusting for birth characteristics and to 1.30 (95% CI 1.07 to 1.59) after further adjustment for socioeconomic factors. For SUDI, the respective HRs were 1.59 (95% CI 1.36 to 1.85) in the unadjusted model, and 1.40 (95% CI 1.20 to 1.63) after accounting for birth characteristics and 1.19 (95% CI 1.02 to 1.39) in the fully adjusted model.ConclusionInterventions that improve maternal health before and during pregnancy to reduce the prevalence of adverse birth characteristics and address poverty could reduce child mortality due to RTIs and SUDIs in England.

scholarly journals Determinants of Full Breastfeeding at 6 Months and Any Breastfeeding at 12 and 24 Months among Women in Sydney: Findings from the HSHK Birth Cohort Study

2020 ◽  
Vol 17 (15) ◽  
pp. 5384
Author(s):  
Ritesh Chimoriya ◽  
Jane Anne Scott ◽  
James Rufus John ◽  
Sameer Bhole ◽  
Andrew Hayen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Breast Milk ◽  
Birth Cohort ◽  
Maternal Education ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Breastfeeding Duration ◽  
Birth Cohort Study ◽  
Full Time ◽  
Increased Risk

The aim of this study was to report on breastfeeding duration up to 24 months and determine the predictors of breastfeeding duration among women in South Western Sydney, one of the most culturally diverse and socioeconomically disadvantaged regions of New South Wales (NSW), Australia. Mother–infant dyads (n = 1035) were recruited to the Healthy Smiles Healthy Kids birth cohort study. Study data were collected through telephone interviews at 2, 4, 8, 12, and 24 months postpartum. Cox proportional hazards models were used to determine factors associated with the risk of stopping full breastfeeding at six months and any breastfeeding at 12 and 24 months. The majority of mothers (92.3%) had initiated breastfeeding. At six months, 13.5% of infants were fully breastfed, while 49.9% received some breast milk. Only 25.5% and 2.9% of infants received some breast milk at 12 and 24 months, respectively. Lower maternal education level, lower socioeconomic status, full-time employment, maternal smoking during pregnancy, and caesarean delivery were associated with increased risk of stopping full breastfeeding at six months and any breastfeeding at 12 and 24 months. Older maternal age and partner’s preference for breastfeeding were associated with an increased likelihood of continuing any breastfeeding at 12 and 24 months. These findings present a number of opportunities for prolonging breastfeeding duration in disadvantaged communities in NSW.

scholarly journals Diarrheal Pathogens Associated with Growth and Neurodevelopment

2021 ◽  
Author(s):  
Jeffrey R Donowitz ◽  
Jeannie Drew ◽  
Mami Taniuchi ◽  
James A Platts-Mills ◽  
Masud Alam ◽  
...  
Keyword(s):  
Cohort Study ◽  
Socioeconomic Factors ◽  
Birth Cohort ◽  
Linear Growth ◽  
Attributable Fraction ◽  
Birth Cohort Study ◽  
Neurodevelopmental Outcomes ◽  
Typical Epec ◽  
Toddler Development ◽  
Pathogen Burden

Abstract Background Diarrheal pathogens have been associated with linear growth deficits. The effect of diarrheal pathogens on growth is likely due to inflammation which also adversely affects neurodevelopment. We hypothesized that diarrheagenic pathogens would be negatively associated with both growth and neurodevelopment. Methods We conducted a longitudinal birth cohort study of 250 children with diarrheal surveillance and measured pathogen burden in diarrheal samples using quantitative PCR. Pathogen attributable fraction estimates (AFe) of diarrhea over the first two years of life, corrected for socioeconomic variables, were used to predict both growth and scores on the Bayley III Scales of Infant and Toddler Development. Results 180 children were analyzed for growth and 162 for neurodevelopmental outcomes. Rotavirus, Campylobacter, and Shigella were the leading causes of diarrhea in year 1 while Shigella, Campylobacter, and ST-ETEC were the leading causes in year 2. Norovirus was the only pathogen associated with LAZ at 24 months and was positively associated (RC 0.42, CI 0.04, 0.80). Norovirus (RC 2.46, CI 0.05 – 4.87) was also positively associated with cognitive scores while sapovirus (RC -2.64, CI -4.80 – -0.48) and Typical EPEC (RC -4.14, CI -8.02 – -0.27) were inversely associated. No pathogens were associated with language or motor scores. Significant maternal, socioeconomic, and perinatal predictors were identified for both growth and neurodevelopment. Conclusion Maternal, prenatal, and socioeconomic factors were common predictors of growth and neurodevelopment. Only a limited number of diarrheal pathogens were associated with these outcomes.

Regional differences in birth size: a comparison between the Helsinki Birth Cohort Study and contemporaneous births on the Åland Islands

2015 ◽  
Vol 6 (4) ◽  
pp. 263-267 ◽  
Author(s):  
S. Sandboge ◽  
J. Fellman ◽  
P. M. Nilsson ◽  
A. W. Eriksson ◽  
C. Osmond ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Marital Status ◽  
Birth Cohort ◽  
Regional Differences ◽  
Multiple Linear Regression Model ◽  
Life Course Perspective ◽  
Birth Cohort Study ◽  
Average Birth Weight ◽  
Birth Characteristics

The Åland Islands were recently ranked as Finland’s healthiest region with lower prevalence of several non-communicable diseases compared with the national mean. We have compared birth characteristics of 1697 individuals born on the Åland Islands between 1937 and 1944 with contemporaneous data from the Helsinki Birth Cohort Study (HBCS;n=11,808). This is a first step towards a potential future analysis of Ålandic health from a life-course perspective. Mean birth weight and length were calculated for both cohorts. Birth weight was entered into a multiple linear regression model with sex, maternal age, marital status and birth year as predictors. Mean birth weight in the Åland cohort was 3499 g, 87 g (95% CI 62; 111) higher compared with the HBCS. Sex and maternal marital status were the strongest predictors of birth weight. More detailed studies are needed to explore the potential effects of this difference in average birth weight between cohorts.

scholarly journals Effect of multiple risk behaviours in adolescence on educational attainment at age 16 years: a UK birth cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020182 ◽  
Author(s):  
Caroline Wright ◽  
Ruth Kipping ◽  
Matthew Hickman ◽  
Rona Campbell ◽  
Jon Heron
Keyword(s):  
Cohort Study ◽  
Educational Attainment ◽  
Birth Cohort ◽  
Outcome Measures ◽  
Population Based ◽  
Birth Cohort Study ◽  
Risk Behaviours ◽  
Additional Risk ◽  
Parents And Children ◽  
Multiple Risk

ObjectivesTo explore the association between adolescent multiple risk behaviours (MRBs) and educational attainment.DesignProspective population-based UK birth cohort study.SettingAvon Longitudinal Study of Parents and Children (ALSPAC), a UK birth cohort of children born in 1991–1992.ParticipantsData on some or all MRB measures were available for 5401 ALSPAC participants who attended a clinic at age 15 years and/or completed a detailed questionnaire at age 16 years. Multiple imputation was used to account for missing data.Primary outcome measuresCapped General Certificate of Secondary Education (GCSE) score and odds of attaining five or more GCSE examinations at grades A*–C. Both outcome measures come from the National Pupil Database and were linked to the ALSPAC data.ResultsEngagement in MRB was strongly associated with poorer educational attainment. Each additional risk equated to −6.31 (95% CI −7.03 to −5.58, p<0.001) in capped GCSE score, equivalent to a one grade reduction or reduced odds of attaining five or more A*–C grades of 23% (OR 0.77, 95% CI 0.74 to 0.81, p<0.001). The average cohort member engaged in 3.24 MRB and therefore have an associated reduction in GCSE score equivalent to three and a half grades in one examination, or reduced odds of attaining five or more A*–C grades of 75%.ConclusionEngagement in adolescent MRB is strongly associated with poorer educational attainment at 16 years. Preventing MRB could improve educational attainment and thereby directly and indirectly improve longer-term health.

scholarly journals Associations of birth characteristics with perimenopausal disorders: a prospective cohort study

2018 ◽  
Vol 10 (02) ◽  
pp. 246-252
Author(s):  
M. Gao ◽  
A. Goodman ◽  
G. Mishra ◽  
I. Koupil
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Incidence Rate ◽  
Gestational Age ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Future Research ◽  
Developmental Origins ◽  
Birth Characteristics ◽  
Birth Records

AbstractPerimenopausal disorders (PDs) are prevalent and importantly affect quality of life among middle-aged women. Yet, very little is known about the developmental origins of these disorders. The objective of this study was to investigate the associations of birth characteristics with PDs. This cohort study is based on archived birth records for birth weight and gestational age, and followed prospectively in Swedish inpatient and outpatient registers for 8 years (n=3212). The main outcomes were menopausal and climacteric states (e.g. flushing, sleeplessness), perimenopausal bleeding and other PDs (e.g. atrophic vaginitis). Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) for three subtypes of PDs separately. During the follow-up, 218 women had PDs, among whom 125 had menopausal and climacteric states, 61 had perimenopausal bleeding and 58 had other PDs as first recorded disorder. Birth weight was linearly associated with incidence rate of menopausal and climacteric states [HR=1.66 per 1 kg increase, 95% confidence interval (95% CI)=1.14–2.41]. Gestational age (rather than birth weight) was associated with incidence rate of other PDs (HR=0.87 per 1 week increase, 95% CI=0.79–0.95). Neither birth weight nor gestational age was associated with perimenopausal bleeding. Similar results were found after adjustment for other early-life and adult socio-demographic characteristics. This observational study provides, for the first time, evidence regarding the developmental origins of PDs. Future research is required to investigate the underlying causal mechanisms, which may shed further light on the etiology of this class of disorders.

scholarly journals Poor Family Relationships in Adolescence and the Risk of Premature Death: Findings from the Stockholm Birth Cohort Study

2019 ◽  
Vol 16 (10) ◽  
pp. 1690 ◽  
Author(s):  
Susanne Alm ◽  
Sara Brolin Låftman ◽  
Hannes Bohman
Keyword(s):  
Cohort Study ◽  
Birth Cohort ◽  
Family Relationships ◽  
Premature Death ◽  
Cox Proportional Hazards ◽  
Birth Cohort Study ◽  
Parental Mental Illness ◽  
Poor Family ◽  
Childhood Conditions ◽  
Increased Risk

Poor family relationships during childhood have been shown to have long-term negative effects on an offspring’s health. However, few studies have followed the offspring to retirement age, and relatedly, knowledge about the link between poor family relationships and premature death is scarce. The aim of this study was to examine the association between poor family relationships in adolescence and the risk of premature death, even when considering other adverse childhood conditions. Prospective data from the Stockholm Birth Cohort study were used, with 2636 individuals born in 1953 who were followed up until age 65. Information on family relations was based on interviews with the participants’ mothers in 1968. Information on mortality was retrieved from administrative register data from 1969–2018. Cox proportional hazards regressions showed that poor family relationships in adolescence were associated with an increased risk of premature death, even when adjusting for childhood conditions in terms of household social class, household economic poverty, contact with the child services, parental alcohol abuse, and parental mental illness (Hazard Ratio (HR), 2.08, 95% Confidence Interval (CI), 1.40–3.09). The findings show that poor family relationships in adolescence can have severe and long-lasting health consequences, highlighting the importance of early interventions.

scholarly journals Risk of SARS-CoV-2 testing, PCR-confirmed infections and COVID-19-related hospital admissions in children and young people: birth cohort study

2021 ◽  
Author(s):  
Pia Hardelid ◽  
Graziella Favarato ◽  
Linda Wijlaars ◽  
Lynda Fenton ◽  
Jim McMenamin ◽  
...  
Keyword(s):  
Young People ◽  
Birth Cohort ◽  
Chronic Conditions ◽  
Proportional Hazards ◽  
Hospital Admissions ◽  
Population Based ◽  
Vital Statistics ◽  
Cox Proportional Hazards ◽  
Birth Cohort Study ◽  
Children And Young People

Background There have been no population-based studies of SARS-CoV-2 testing, PCR-confirmed infections and COVID-19-related hospital admissions across the full paediatric age range. We examine the epidemiology of SARS-CoV-2 in children and young people (CYP) aged <23 years. Methods We used a birth cohort of all children born in Scotland since 1997, constructed via linkage between vital statistics, hospital records and SARS-CoV-2 surveillance data. We calculated risks of tests and PCR-confirmed infections per 1000 CYP-years between August and December 2020, and COVID-19-related hospital admissions per 100,000 CYP-years between February and December 2020. We used Poisson and Cox proportional hazards regression models to determine risk factors. Results Among the 1226855 CYP in the cohort, there were 378402 tests, 19005 PCR confirmed infections and 346 admissions, corresponding to rates of 770.8/1000 (95% confidence interval 768.4-773.3), 179.4 (176.9-182.0) and 29.4/100,000 (26.3-32.8) CYP-years respectively. Infants had the highest COVID-19-related admission rates. Chronic conditions, particularly multiple types of conditions, was strongly associated with COVID-19-related admissions across all ages. The hazard ratio for >1 chronic condition type was 12.2 (7.9-18.82) compared to children with no chronic conditions. 89% of admitted children had no chronic conditions recorded. Conclusions Infants, and CYP with chronic conditions are at highest risk of admission with COVID-19, however the majority of admitted CYP have no chronic conditions. These results provide evidence to support risk/benefit analyses for paediatric COVID-19 vaccination programmes. Studies examining whether maternal vaccine during pregnancy prevents COVID-19 admissions in infants are urgently needed. Funding UK Research and Innovation-Medical Research Council

scholarly journals Child mortality in England compared with Sweden: a birth cohort study

The Lancet ◽  
2018 ◽  
Vol 391 (10134) ◽  
pp. 2008-2018 ◽  
Author(s):  
Ania Zylbersztejn ◽  
Ruth Gilbert ◽  
Anders Hjern ◽  
Linda Wijlaars ◽  
Pia Hardelid
Keyword(s):  
Cohort Study ◽  
Birth Cohort ◽  
Child Mortality ◽  
Birth Cohort Study
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