scholarly journals Perinatal factors and hospitalisations for severe childhood infections: a population-based cohort study in Sweden

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e054083
Author(s):  
Samuel Videholm ◽  
Urban Kostenniemi ◽  
Torbjörn Lind ◽  
Sven-Arne Silfverdal
Keyword(s):  
Cohort Study ◽  
Young Children ◽  
Bacterial Meningitis ◽  
Gestational Age ◽  
Negative Binomial ◽  
Hospital Admissions ◽  
Population Based ◽  
Perinatal Factors ◽  
Increased Risk ◽  
Severe Infections

ObjectiveTo examine the association between perinatal factors and hospitalisations for sepsis and bacterial meningitis in early childhood (from 28 days to 2 years of age).DesignA population‐based cohort study. The Swedish Medical Birth Register was combined with the National Inpatient Register, the Cause of Death Register, the Total Population Register and the Longitudinal integration database for health insurance and labour market studies. Associations between perinatal factors and hospitalisations were examined using negative binomial regression models.SettingSweden.Participants1 406 547 children born in Sweden between 1997 and 2013.Main outcome measuresHospital admissions for sepsis and bacterial meningitis recorded between 28 days and 2 years of life.ResultsGestational age was inversely associated with severe infections, that is, extreme prematurity was strongly associated with an increased risk of sepsis, adjusted incidence rate ratio (aIRR) 10.37 (95% CI 6.78 to 15.86) and meningitis aIRR 6.22 (95% CI 2.28 to 16.94). The presence of congenital malformation was associated with sepsis aIRR 3.89 (95% CI 3.17 to 4.77) and meningitis aIRR 1.69 (95% CI 1.09 to 2.62). Moreover, children born small or large for gestational age were more likely to be hospitalised for sepsis and children exposed to maternal smoking were more likely to be hospitalised for meningitis.ConclusionsPrematurity and several other perinatal factors were associated with an increased risk of severe infections in young children. Therefore, clinical guidelines for risk assessment of infections in young children should consider perinatal factors.

scholarly journals Coeliac disease and invasive pneumococcal disease: a population-based cohort study

2017 ◽  
Vol 145 (6) ◽  
pp. 1203-1209 ◽  
Author(s):  
A. RÖCKERT TJERNBERG ◽  
J. BONNEDAHL ◽  
M. INGHAMMAR ◽  
A. EGESTEN ◽  
G. KAHLMETER ◽  
...  
Keyword(s):  
Cohort Study ◽  
Coeliac Disease ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Cox Regression ◽  
Statistical Significance ◽  
Pneumococcal Vaccination ◽  
Population Based ◽  
Increased Risk ◽  
Severe Infections

SUMMARYSevere infections are recognized complications of coeliac disease (CD). In the present study we aimed to examine whether individuals with CD are at increased risk of invasive pneumococcal disease (IPD). To do so, we performed a population-based cohort study including 29 012 individuals with biopsy-proven CD identified through biopsy reports from all pathology departments in Sweden. Each individual with CD was matched with up to five controls (n = 144 257). IPD events were identified through regional and national microbiological databases, including the National Surveillance System for Infectious Diseases. We used Cox regression analyses to estimate hazard ratios (HRs) for diagnosed IPD. A total of 207 individuals had a record of IPD whereas 45/29 012 had CD (0·15%) and 162/144 257 were controls (0·11%). This corresponded to a 46% increased risk for IPD [HR 1·46, 95% confidence interval (CI) 1·05–2·03]. The risk estimate was similar after adjustment for socioeconomic status, educational level and comorbidities, but then failed to attain statistical significance (adjusted HR 1·40, 95% CI 0·99–1·97). Nonetheless, our study shows a trend towards an increased risk for IPD in CD patients. The findings support results seen in earlier research and taking that into consideration individuals with CD may be considered for pneumococcal vaccination.

scholarly journals Association between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in England

BMJ ◽  
2021 ◽  
pp. n628 ◽  
Author(s):  
Harriet Forbes ◽  
Caroline E Morton ◽  
Seb Bacon ◽  
Helen I McDonald ◽  
Caroline Minassian ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Hospital Admissions ◽  
Absolute Risk ◽  
Population Based ◽  
Intensive Care Admission ◽  
Risk Of Death ◽  
Hazard Ratios ◽  
Increased Risk ◽  
The Uk

Abstract Objective To investigate whether risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and outcomes of coronavirus disease 2019 (covid-19) differed between adults living with and without children during the first two waves of the UK pandemic. Design Population based cohort study, on behalf of NHS England. Setting Primary care data and pseudonymously linked hospital and intensive care admissions and death records from England, during wave 1 (1 February to 31 August 2020) and wave 2 (1 September to 18 December 2020). Participants Two cohorts of adults (18 years and over) registered at a general practice on 1 February 2020 and 1 September 2020. Main outcome measures Adjusted hazard ratios for SARS-CoV-2 infection, covid-19 related admission to hospital or intensive care, or death from covid-19, by presence of children in the household. Results Among 9 334 392 adults aged 65 years and under, during wave 1, living with children was not associated with materially increased risks of recorded SARS-CoV-2 infection, covid-19 related hospital or intensive care admission, or death from covid-19. In wave 2, among adults aged 65 years and under, living with children of any age was associated with an increased risk of recorded SARS-CoV-2 infection (hazard ratio 1.06 (95% confidence interval 1.05 to 1.08) for living with children aged 0-11 years; 1.22 (1.20 to 1.24) for living with children aged 12-18 years) and covid-19 related hospital admission (1.18 (1.06 to 1.31) for living with children aged 0-11; 1.26 (1.12 to 1.40) for living with children aged 12-18). Living with children aged 0-11 was associated with reduced risk of death from both covid-19 and non-covid-19 causes in both waves; living with children of any age was also associated with lower risk of dying from non-covid-19 causes. For adults 65 years and under during wave 2, living with children aged 0-11 years was associated with an increased absolute risk of having SARS-CoV-2 infection recorded of 40-60 per 10 000 people, from 810 to between 850 and 870, and an increase in the number of hospital admissions of 1-5 per 10 000 people, from 160 to between 161 and 165. Living with children aged 12-18 years was associated with an increase of 160-190 per 10 000 in the number of SARS-CoV-2 infections and an increase of 2-6 per 10 000 in the number of hospital admissions. Conclusions In contrast to wave 1, evidence existed of increased risk of reported SARS-CoV-2 infection and covid-19 outcomes among adults living with children during wave 2. However, this did not translate into a materially increased risk of covid-19 mortality, and absolute increases in risk were small.

scholarly journals Risk of adverse events associated with upper and lower endoscopic ultrasound: a population-based cohort study

2021 ◽  
Vol 09 (09) ◽  
pp. E1427-E1434
Author(s):  
Roshan Razik ◽  
Paul D. James ◽  
Rishad Khan ◽  
Courtney Maxwell ◽  
Yibing Ruan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adverse Events ◽  
Endoscopic Ultrasound ◽  
Hospital Admissions ◽  
Multivariable Analysis ◽  
Needle Aspiration ◽  
Population Based ◽  
Emergency Department Visits ◽  
Therapeutic Interventions ◽  
Increased Risk

Abstract Background and study aim Endoscopic ultrasound (EUS) enables diagnostic evaluation and therapeutic interventions but is associated with adverse events. We conducted a population-based cohort study to determine the risk of adverse events for upper and lower EUS with and without fine-needle aspiration (FNA). Patients and methods All adults who underwent EUS and resided in Calgary in 2007–2013 were included. Endoscopy and provincial databases were used to identify EUS procedures, unplanned emergency department visits, and hospital admissions within 30 days of the procedures, which were then characterized through formal chart review. Adverse events were defined a priori and classified as definitely, possibly, or not related to EUS. The primary outcome was 30-day risk of adverse events classified as definitely or possibly related to EUS. Univariable and multivariable analyses were conducted with risk factors known to be associated with EUS adverse events. Results 2895 patients underwent 3552 EUS procedures: 3034 (85 %) upper EUS, of which 710 (23 %) included FNA, and 518 (15 %) lower EUS, of which 23 (4 %) involved FNA. Overall, 69 procedures (2 %) involved an adverse event that was either definitely or possibly related to EUS, with 33 (1 %) requiring hospitalization. None of the adverse events required intensive care or resulted in death. On multivariable analysis, only FNA was associated with increased risk of adverse events (odds ratio 6.43, 95 % confidence interval 3.92–10.55; P < 0.001). Conclusion Upper and lower EUS were generally safe but FNA substantially increased the risk of adverse events. EUS-related complications requiring hospitalization were rare.

scholarly journals Postpartum Severe Acute Maternal Morbidity According to Gestational Age at Delivery in Twin Pregnancies: A Prospective Cohort Study

2021 ◽  
Author(s):  
Lola Loussert ◽  
Catherine Deneux-Tharaux ◽  
Aurélien Seco ◽  
Francois Goffinet ◽  
diane korb ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Gestational Age ◽  
Prospective Cohort ◽  
Maternal Morbidity ◽  
Population Based ◽  
Severe Acute Maternal Morbidity ◽  
Increased Risk ◽  
Gestational Age At Delivery ◽  
Twin Pregnancies

Objective: To assess the association between gestational age at delivery and postpartum severe acute maternal morbidity (SAMM) in twin pregnancies. Design: Population-based, national, prospective, cohort study Setting: From 02/2014 to 03/2015 in France Population: Women with twin pregnancies who gave birth after 32 weeks of gestation. We excluded women with fetal death or medical termination of either twin, with antepartum SAMM, with antepartum conditions responsible for postpartum SAMM. Methods: Gestational age at delivery was studied as the number of completed weeks of gestation. We assessed the association between gestational age at delivery and postpartum SAMM by using multivariable multilevel modified Poisson regression modelling. Main Outcome Measures: Composite criteria of postpartum severe acute maternal morbidity Results: Among the 7,713 women included, 410 (5.3%) developed postpartum SAMM, mainly (88.5%) postpartum haemorrhage. Compared with the reference category of 37 weeks, the risk of postpartum SAMM was significantly lower for all categories of earlier gestational age at delivery (from aRR=0.34, 95% CI 0.17-0.68 at 32 weeks to aRR=0.71, 95% CI 0.54-0.94 at 36 weeks), and did not differ for later categories. Conclusion: In twin pregnancies, compared with delivery at 37 weeks, delivery at earlier gestational ages is associated with a lower risk of postpartum SAMM. Continuing pregnancy beyond 37 weeks is not associated with an increased risk of postpartum SAMM. Funding: Supported by a grant from the French Ministry of Health (Programme Hospitalier de Recherche Clinique, AOM2012) and a grant from Université Toulouse III. Keywords: severe acute maternal morbidity, twin pregnancy, timing of delivery

scholarly journals Multiplicity and early gestational age contribute to an increased risk of cerebral palsy from assisted conception: a population-based cohort study

2010 ◽  
Vol 25 (8) ◽  
pp. 2115-2123 ◽  
Author(s):  
D. Hvidtjorn ◽  
J. Grove ◽  
D. Schendel ◽  
C. Svaerke ◽  
L. A. Schieve ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Cohort Study ◽  
Gestational Age ◽  
Population Based ◽  
Assisted Conception ◽  
Increased Risk

scholarly journals Maternal lithium use and the risk of adverse pregnancy and neonatal outcomes: a Swedish population-based cohort study

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Roxanne Hastie ◽  
Stephen Tong ◽  
Richard Hiscock ◽  
Anthea Lindquist ◽  
Linda Lindström ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Gestational Age ◽  
Population Based ◽  
Neonatal Outcomes ◽  
Large For Gestational Age ◽  
Adjusted Relative Risk ◽  
Spontaneous Preterm Birth ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract Background Lithium is prescribed during pregnancy, but there is limited information about pregnancy and neonatal outcomes following in utero exposure. Thus, this study aimed to investigate the associations between lithium use and adverse pregnancy and neonatal outcomes. Methods This population-based cohort study examined associations between maternal lithium use and major adverse pregnancy and neonatal outcomes via inverse probability weighted propensity score regression models. Results Of 854,017 women included in this study, 434 (0.05%) used lithium during pregnancy. Among pre-specified primary outcomes, lithium use during pregnancy was associated with an increased risk of spontaneous preterm birth (8.7% vs 3.0%; adjusted relative risk [aRR] 2.64 95% CI 1.82, 3.82) and birth of a large for gestational age infant (9.0% vs 3.5%; aRR 2.64 95% CI 1.91, 3.66), but not preeclampsia nor birth of a small for gestational age infant. Among secondary outcomes, lithium use was associated with an increased risk of cardiac malformations (2.1% vs 0.8%; aRR 3.17 95% CI 1.64, 6.13). In an analysis restricted to pregnant women with a diagnosed psychiatric illness (n=9552), associations remained between lithium and spontaneous preterm birth, birth of a large for gestational age infant, and cardiovascular malformations; and a positive association with neonatal hypoglycaemia was also found. These associations were also apparent in a further analysis comparing women who continued lithium treatment during pregnancy to those who discontinued prior to pregnancy. Conclusions Lithium use during pregnancy is associated with an increased risk of spontaneous preterm birth and other adverse neonatal outcomes. These potential risks must be balanced against the important benefit of treatment and should be used to guide shared decision-making.

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