Caesarean section and the association with migraine: a retrospective register-linked HUNT population cohort study

ObjectivesTo evaluate the association between caesarean section and migraine in a population-based register-linked cohort study.SettingData from the population-based Nord-Trøndelag Health Studies (HUNT2 and HUNT3) were linked to information from the Norwegian Medical Birth Registry.Participants65 343 participants responded to the headache questions in any of the two HUNT studies. Only those answering the headache questions in HUNT2 or 3 and had information about mode of delivery in the Norwegian Medical Birth Registry (born after 1967) were included. Our final sample consisted of 6592 women and 4602 men, aged 19–41 years.OutcomesORs for migraine given caesarean section. Analyses were performed in multivariate logistic regression models.ResultsAfter adjusting for sex, age and fetal growth restriction, delivery by caesarean section was not associated with migraine later in life (OR 0.86, 95% CI 0.64 to 1.15). Delivery by caesarean section was associated with a reduced OR of non-migrainous headache (OR 0.77, 95% CI 0.60 to 0.99).ConclusionNo association was found between caesarean section and migraine in this population-based register-linked study.

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Obstetrical mode of delivery and behavioural outcomes in childhood and adolescence: findings from the Millennium Cohort Study

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-022-02233-x ◽

2022 ◽

Author(s):

Gillian M. Maher ◽

Ali S. Khashan ◽

Fergus P. McCarthy

Keyword(s):

Logistic Regression ◽

Cohort Study ◽

Caesarean Section ◽

Vaginal Delivery ◽

Repeated Measures ◽

Multiple Testing ◽

Mode Of Delivery ◽

Childhood And Adolescence ◽

Millennium Cohort Study ◽

Adjusted Logistic Regression

Abstract Purpose To examine the association between mode of delivery (in particular caesarean section) and behavioural outcomes in offspring at six time-points between age 3 and 17 years. Methods Similar to previous work examining the association between mode of delivery and behavioural outcomes in offspring at age 7, we used maternal-reported data from the Millennium Cohort Study. Data on mode of delivery were collected when children were 9 months and categorised as spontaneous vaginal delivery, assisted vaginal delivery, induced vaginal delivery, emergency caesarean section, planned caesarean section and caesarean section after induction of labor. Data on behavioural outcomes were collected at ages 3, 5, 7, 11, 14 and 17 years using the Strengths and Difficulties Questionnaire (SDQ). Crude and adjusted logistic regression examined mode of delivery–behavioural difficulties relationship, using validated SDQ cut-off points (total SDQ ≥ 17, emotional ≥ 5, conduct ≥ 4, hyperactivity ≥ 7, peer problems ≥ 4 and prosocial behaviour ≤ 4). Multilevel models with linear splines examined the association between mode of delivery and repeated measures of SDQ. Results There were 18,213 singleton mother–child pairs included at baseline, 13,600 at age 3; 13,831 at age 5; 12,687 at age 7; 11,055 at age 11; 10,745 at age 14 and 8839 at age 17. Adjusted logistic regression suggested few associations between mode of delivery and behavioural outcomes at ages 3, 5, 11, 14 and 17 years using validated SDQ cut-off points. After correction for multiple testing, only the protective association between planned caesarean section-Conduct difficulties at age 5 years (OR 0.63, 95% CI 0.46, 0.85) and positive association between caesarean section after induction-Emotional difficulties at age 11 years (OR 1.57, 95% CI 1.19, 2.07) remained statistically significant. Multilevel modelling suggested mean SDQ scores were similar in each mode of delivery group at each time point. Conclusions Results of this study indicate that mode of delivery is unlikely to have a major impact on behavioural outcomes.

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Late Pregnancy Vitamin D Deficiency is Associated with Doubled Odds of Birth Asphyxia and Emergency Caesarean Section: A Prospective Cohort Study

Maternal and Child Health Journal ◽

10.1007/s10995-020-02999-z ◽

2020 ◽

Vol 24 (11) ◽

pp. 1412-1418

Author(s):

Hanna Augustin ◽

Sinead Mulcahy ◽

Inez Schoenmakers ◽

Maria Bullarbo ◽

Anna Glantz ◽

...

Keyword(s):

Vitamin D ◽

Cohort Study ◽

Caesarean Section ◽

Vitamin D Deficiency ◽

Epidural Anaesthesia ◽

Birth Asphyxia ◽

Late Pregnancy ◽

Population Based ◽

Emergency Caesarean Section ◽

Vitamin D Status

Abstract Objectives The aim of this prospective cohort study was to investigate the associations between maternal vitamin D status in late pregnancy and emergency caesarean section (EMCS) and birth asphyxia, in a population based sample of women in Sweden. Methods Pregnant women were recruited at the antenatal care in Sweden and 1832 women were included after exclusion of miscarriages, terminated pregnancies and missing data on vitamin D status. Mode of delivery was retrieved from medical records. EMCS was defined as caesarean section after onset of labour. Birth asphyxia was defined as either 5 min Apgar score < 7 or arterial umbilical cord pH < 7.1. Serum was sampled in the third trimester of pregnancy (T3) and 25-hydroxyvitamin D (25OHD) was analysed by liquid chromatography tandem mass spectrometry. Vitamin D deficiency was defined as 25OHD < 30 nmol/L, and associations were studied using logistic regression analysis and expressed as adjusted odds ratios (AOR). Results In total, 141 (7.7%) women had an EMCS and 58 (3.2%) children were born with birth asphyxia. Vitamin D deficiency was only associated with higher odds of EMCS in women without epidural anaesthesia (AOR = 2.01, p = 0.044). Vitamin D deficiency was also associated with higher odds of birth asphyxia (AOR = 2.22, p = 0.044). Conclusions for Practice In this Swedish prospective population-based cohort study, vitamin D deficiency in late pregnancy was associated with doubled odds of birth asphyxia and with EMCS in deliveries not aided by epidural anaesthesia. Prevention of vitamin D deficiency among pregnant women may reduce the incidence of EMCS and birth asphyxia. The mechanism behind the findings require further investigation.

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The Wuhan Twin Birth Cohort (WTBC)

Twin Research and Human Genetics ◽

10.1017/thg.2017.24 ◽

2017 ◽

Vol 20 (4) ◽

pp. 355-362

Author(s):

Jinzhu Zhao ◽

Shaoping Yang ◽

Anna Peng ◽

Zhengmin Qian ◽

Hong Xian ◽

...

Keyword(s):

Cohort Study ◽

Birth Cohort ◽

Medical Information ◽

First Trimester ◽

Population Based ◽

Health Examination ◽

Birth Registry ◽

Twin Birth ◽

First Trimester Of Pregnancy

The Wuhan Pre/Post-Natal Twin Birth Registry (WPTBR) is one of the largest twin birth registries with comprehensive medical information in China. It recruits women from the first trimester of pregnancy and their twins from birth. From January 2006 to May 2016, the total number of twins enrolled in WPTBR is 13,869 twin pairs (27,553 individuals). The WPTBR initiated the Wuhan Twin Birth Cohort (WTBC). The WTBC is a prospective cohort study carried out through incorporation of three samples. The first one comprises 6,920 twin pairs, and the second one, 6,949 twin pairs. Both are population-based samples linked to the WPTBR and include pre- and post-natal information from WPTBR. The second sample includes neonatal blood spots as well. Using a hospital-based approach, we recently developed a third sample with a target enrolment of 1,000 twin pairs and their mothers. These twins are invited, via their parents, to participate in a periodic health examination from the first trimester of pregnancy to 18 years. Biological samples are collected initially from the mother, including blood, urine, cord blood, cord, amniotic fluid, placenta, breast milk and meconium, and vaginal secretions, and later from the twins, including meconium, stool, urine, and blood. This article describes the design, recruitment, follow-up, data collection, and measures, as well as ongoing and planned analyses at the WTBC. The WTBC offers a unique opportunity to follow women from prenatal to postnatal, as well as follow-up of their twins. This cohort study will expand the understanding of genetic and environmental influences on pregnancy and twins’ development in China.

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Malformations in Twins and Their Siblings, Norway, 1967-79

Acta geneticae medicae et gemellologiae twin research ◽

10.1017/s0001566000007558 ◽

1984 ◽

Vol 33 (1) ◽

pp. 87-95 ◽

Cited By ~ 44

Author(s):

G.C. Windham ◽

T. Bjerkedal

Keyword(s):

Rate Ratio ◽

Common Factors ◽

Hip Dislocation ◽

Population Based ◽

Total Rate ◽

Congenital Hip Dislocation ◽

Birth Registry ◽

Medical Birth Registry ◽

Cardiovascular Defects ◽

Low Incidence

AbstractDuring 1967-79 the population-based Medical Birth Registry of Norway registered 7,660 twin pairs (1% of births) born to 7,596 mothers, who gave birth to 6,608 additional infants (twin siblings). The total rate of malformations among twins (278.1/10,000) was not significantly different than among singletons (302.1/10,000), nor among twin siblings (314.8/10,000). By specific type of defect, twins had significantly higher rates than singletons of central nervous system (CNS) defects (Rate Ratio = 1.8) and cardiovascular defects (RR = 1.5). The twins also had a significantly low rate of congenital hip dislocation (RR = 0.4), which may explain the relatively low incidence of malformations in twins. Like-sex (LS) twins had a slightly higher rate of malformations than unlike-sex (US) twins (RR = 1.1), as well as a higher rate of CNS defects (RR = 3.0). The siblings also had a significantly increased rate of CNS defects compared to singletons (RR = 1.9), but not of cardiovascular defects (RR = 0.9). The results indicate that twins have elevated rates of at least some congenital malformations. The observations about CNS defects suggest common factors that can lead to either like-sex twinning, CNS defects, or both. The increased frequency of cardiovascular defects in twins appears to be associated with the biologic conditions of twinning.

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Biometrical modelling in genetics: are complex traits too complex?

Statistical Methods in Medical Research ◽

10.1177/0962280207081241 ◽

2008 ◽

Vol 17 (1) ◽

pp. 75-96 ◽

Cited By ~ 3

Author(s):

Håkon K. Gjessing ◽

Rolv Terje Lie

Keyword(s):

Complex Traits ◽

Nuclear Family ◽

Population Based ◽

Mixed Effects ◽

Mixed Effects Models ◽

Birth Registry ◽

Environmental Correlations ◽

Biological Trait ◽

Medical Birth Registry ◽

Genetic And Environmental Factors

The field of traditional biometrical genetics uses mixed-effects models to quantify the influence of genetic and environmental factors on a biological trait, based essentially on estimating within-family trait correlations. Such analyses provide a useful preview of what may be discovered with the emerging full-scale genotyping strategies. However, biometrical analyses require unrealistically large sample sizes to obtain a reasonable precision, particularly for dichotomous traits. In addition, it may be very difficult to separate genetic and environmental effects because environmental correlations are poorly understood. We illustrate these and other difficulties using population-based cousins and nuclear family data for birth weight, collected from the Medical Birth Registry of Norway.

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Burden of Post-COVID-19 Syndrome and Implications for Healthcare Service Planning: A Population-based Cohort Study

10.1101/2021.02.27.21252572 ◽

2021 ◽

Author(s):

Dominik Menges ◽

Tala Ballouz ◽

Alexia Anagnostopoulos ◽

Hélène E Aschmann ◽

Anja Domenghino ◽

...

Keyword(s):

Cohort Study ◽

General Population ◽

Healthcare Services ◽

Population Based ◽

Acute Illness ◽

Service Planning ◽

General Practitioner Visit ◽

Physical And Mental Health ◽

Patient Centered ◽

Logistic Regression Models

AbstractBackgroundLonger-term consequences after SARS-CoV-2 infection are becoming an important burden to societies and healthcare systems. Data on post-COVID-19 syndrome in the general population are required for the timely planning of healthcare services and resources. The objective of this study was to assess the prevalence of impaired health status and physical and mental health symptoms among individuals at least six months after SARS-CoV-2 infection, and to characterize their healthcare utilization.MethodsThis population-based prospective cohort study (Zurich SARS-CoV-2 Cohort) enrolled 431 adults from the general population with polymerase chain reaction-confirmed SARS-CoV-2 infection reported to health authorities between 27 February 2020 and 05 August 2020 in the Canton of Zurich, Switzerland. We evaluated the proportion of individuals reporting not to have fully recovered since SARS-CoV-2 infection, and the proportion reporting fatigue (Fatigue Assessment Scale), dyspnea (mMRC dyspnea scale) or depression (DASS-21) at six to eight months after diagnosis. Furthermore, the proportion of individuals with at least one healthcare contact after their acute illness was evaluated. Multivariable logistic regression models were used to assess factors associated with these main outcomes.ResultsSymptoms were present in 385 (89%) participants at diagnosis and 81 (19%) were initially hospitalized. At six to eight months, 111 (26%) reported not having fully recovered. 233 (55%) participants reported symptoms of fatigue, 96 (25%) had at least grade 1 dyspnea, and 111 (26%) had DASS-21 scores indicating symptoms of depression. 170 (40%) participants reported at least one general practitioner visit related to COVID-19 after acute illness, and 10% (8/81) of initially hospitalized individuals were rehospitalized. Individuals that have not fully recovered or suffer from fatigue, dyspnea or depression were more likely to have further healthcare contacts. However, a third of individuals (37/111) that have not fully recovered did not seek further care.ConclusionsIn this population-based study, a relevant proportion of participants suffered from longer-term consequences after SARS-CoV-2 infection. With millions infected across the world, our findings emphasize the need for the timely planning of resources and patient-centered services for post-COVID-19 care.RegistrationISRCTN14990068

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Epidemiology of limb reduction defects as registered in the Medical Birth Registry of Norway, 1970-2016: Population based study

PLoS ONE ◽

10.1371/journal.pone.0219930 ◽

2019 ◽

Vol 14 (7) ◽

pp. e0219930 ◽

Cited By ~ 4

Author(s):

Kari Klungsøyr ◽

Tone Irene Nordtveit ◽

Trine Sand Kaastad ◽

Sigrun Solberg ◽

Ida Neergård Sletten ◽

...

Keyword(s):

Population Based ◽

Birth Registry ◽

Population Based Study ◽

Limb Reduction ◽

Medical Birth Registry

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Antibiotic exposure during pregnancy and childhood asthma: a national birth cohort study investigating timing of exposure and mode of delivery

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-319659 ◽

2021 ◽

pp. archdischild-2020-319659 ◽

Cited By ~ 1

Author(s):

Cecilie Skaarup Uldbjerg ◽

Jessica E Miller ◽

David Burgner ◽

Lars Henning Pedersen ◽

Bodil Hammer Bech

Keyword(s):

Cohort Study ◽

Caesarean Section ◽

Birth Cohort ◽

Childhood Asthma ◽

Mode Of Delivery ◽

First Trimester ◽

Birth Cohort Study ◽

Antibiotic Exposure ◽

Exposure During Pregnancy ◽

Timing Of Exposure

ObjectiveTo investigate whether antibiotic exposure during pregnancy was associated with childhood asthma and if this relationship was conditional on timing of exposure and mode of delivery.DesignA cohort study using multivariable logistic regression models adjusting for a priori defined confounders. Pregnant women were recruited from 1996 to 2002.SettingThe Danish National Birth Cohort.PatientsOf the 96 832 children in the cohort, 32 651 children were included in the study population.Main outcome measureParent-reported childhood asthma at 11 years.ResultsA total of 5522 (17%) children were born to mothers exposed to antibiotics during pregnancy. In adjusted analyses, children born to exposed mothers had higher odds of asthma (OR 1.14, 95% CI 1.05 to 1.24). There was no association with antibiotic exposure in the first trimester (OR 1.02, 95% CI 0.83 to 1.26), but higher odds were observed for antibiotic exposure in the second to third trimester (OR 1.17, 95% CI 1.06 to 1.28), compared with unexposed children. The overall association between antibiotics during pregnancy and childhood asthma was only observed in vaginally born children (OR 1.17, 95% CI 1.07 to 1.28) but not in caesarean section born children (planned caesarean section: OR 0.95, 95% CI 0.66 to 1.37; caesarean emergency: OR 0.96, 95% CI 0.73 to 1.28). In exposed vaginally born children, the odds for childhood asthma requiring treatment during the preceding year were 34% higher (OR 1.34, 95% CI 1.21 to 1.49), compared with unexposed vaginally born children.ConclusionsAntibiotic exposure in mid-to-late pregnancy is associated with higher odds of childhood asthma in vaginally born children. Mode of delivery may modify the association.

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Differences in rates and odds for emergency caesarean section in six Palestinian hospitals: a population-based birth cohort study

BMJ Open ◽

10.1136/bmjopen-2017-019509 ◽

2018 ◽

Vol 8 (3) ◽

pp. e019509 ◽

Cited By ~ 7

Author(s):

Mohammed Zimmo ◽

Katariina Laine ◽

Sahar Hassan ◽

Erik Fosse ◽

Marit Lieng ◽

...

Keyword(s):

Cohort Study ◽

Caesarean Section ◽

Birth Cohort ◽

Population Based ◽

Emergency Caesarean Section ◽

Birth Cohort Study ◽

Emergency Caesarean ◽

Reference Hospital ◽

Primiparous Women ◽

Singleton Pregnancies

ObjectiveTo assess the differences in rates and odds for emergency caesarean section among singleton pregnancies in six governmental Palestinian hospitals.DesignA prospective population-based birth cohort study.SettingObstetric departments in six governmental Palestinian hospitals.Participants32 321 women scheduled to deliver vaginally from 1 March 2015 until 29 February 2016.MethodsTo assess differences in sociodemographic and antenatal obstetric characteristics by hospital, χ2test, analysis of variance and Kruskal-Wallis test were applied. Logistic regression was used to estimate differences in odds for emergency caesarean section, and ORs with 95% CIs were assessed.Main outcome measuresThe primary outcome was the adjusted ORs of emergency caesarean section among singleton pregnancies for five Palestinian hospitals as compared with the reference (Hospital 1).ResultsThe prevalence of emergency caesarean section varied across hospitals, ranging from 5.8% to 22.6% among primiparous women and between 4.8% and 13.1% among parous women. Compared with the reference hospital, the ORs for emergency caesarean section were increased in all other hospitals, crude ORs ranging from 1.95 (95% CI 1.42 to 2.67) to 4.75 (95% CI 3.49 to 6.46) among primiparous women. For parous women, these differences were less pronounced, crude ORs ranging from 1.37 (95% CI 1.13 to 1.67) to 2.99 (95% CI 2.44 to 3.65). After adjustment for potential confounders, the ORs were reduced but still statistically significant, except for one hospital among parous women.ConclusionSubstantial differences in odds for emergency caesarean section between the six Palestinian governmental hospitals were observed. These could not be explained by the studied sociodemographic or antenatal obstetric characteristics.

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