Association between the use of antidepressants and the risk of preterm birth among pregnant women with depression: a retrospective cohort study in Taiwan

Our study was aimed to investigate the association between the use of antidepressants and the risk of preterm birth in pregnant women who have had perinatal depression. We extracted data from the Taiwanese National Health Insurance Research Database (NHIRD) and analyzed them using multivariate Cox proportional hazard regression models. Identified from the NHIRD, we matched 1789 women aged 18–55 years who were using antidepressants during pregnancy and 1789 women who were experiencing depression but who were not using antidepressants during pregnancy for age, index date, and medical comorbidities. We enrolled the women in our study, which we conducted using 12 years’ worth of data between 2000 and 2012, and then followed up individually with them for up to 1 year to identify any occurrence of preterm birth. Results highlighted that, compared with the women with perinatal depression who were not using antidepressants during pregnancy, the women taking antidepressants had a 1.762-fold risk of preterm birth (adjusted HR=1.762, 95% CI 1.351 to 2.294, p<0.001). The use of antidepressants in women with perinatal depression may increase the risk of preterm birth. However, the decision to start, stop, or change the use of antidepressants during pregnancy requires evaluating the risks of treatment versus untreated depression for both mother and child.

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The elevated risk of sight-threatening cataract in diabetes with retinopathy: a retrospective population-based cohort study

BMC Ophthalmology ◽

10.1186/s12886-021-02114-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chan-Wei Nien ◽

Chia-Yi Lee ◽

Hung-Chi Chen ◽

Shih-Chun Chao ◽

Hung-Jui Hsu ◽

...

Keyword(s):

Cataract Surgery ◽

Multivariable Analysis ◽

Population Based ◽

Cumulative Probability ◽

Control Group ◽

Study Group ◽

Research Database ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Cox Proportional Hazard Regression

Abstract Background The effect of diabetic retinopathy (DR) on the development of sight-threatening cataracts was assessed using the National Health Insurance Research Database of Taiwan. Methods Patients diagnosed with diabetes mellitus (DM) and DR were enrolled in the study group. Age- and sex-matched DM individuals without DR and patients without DM served as the DM control group and non-DM control group, respectively, both with 1:4 ratios. The outcome was set as the performance of cataract surgery. Cox proportional hazard regression was used to calculate the adjusted hazard ratio (aHR) of DR considering multiple factors underlying cataract formation. Results A total of 3297 DR patients, 13,188 DM control patients and 13,188 non-DM control subjects were enrolled. The study group included 919 events of sight-threatening cataracts (27.87%), the DM control group included 1108 events (8.40%), and the non-DM control group included 957 events (7.26%). A multivariable analysis indicated that the study group presented a higher aHR of cataract surgery (2.93, 95% CI: 2.60–3.30) and a higher cumulative probability of cataract surgery than both the DM control and non-DM control groups (both log rank P < 0.001). In addition, both the proliferative DR (3.90, 95% CI: 3.42–4.45) and nonproliferative DR (2.35, 95% CI: 2.08–2.65) subgroups showed a higher aHR of cataract surgery than the DM control group. Conclusion The presence of DR increases the risk of sight-threatening cataracts that warrant surgery, and the effect is prominent among patients with both proliferative DR and nonproliferative DR.

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The association between dietary glycemic and insulin indices with incidence of cardiovascular disease: Tehran lipid and glucose study

BMC Public Health ◽

10.1186/s12889-020-09586-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Farshad Teymoori ◽

Hossein Farhadnejad ◽

Parvin Mirmiran ◽

Milad Nazarzadeh ◽

Fereidoun Azizi

Keyword(s):

Cardiovascular Disease ◽

Regression Models ◽

Glycemic Load ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Daily Energy ◽

Glycemic Indices ◽

The Mean ◽

Cox Proportional Hazard Regression

Abstract Background The present study was conducted to investigate the association of dietary insulin index(II), insulin load(IL), glycemic index(GI), and glycemic load(GL) with the risk of cardiovascular disease(CVD). Methods This cohort study was conducted within the framework of the Tehran Lipid and Glucose Study on 2198 subjects, aged≥19 years old, who were followed-up for a median (IQR) 6.7 (6.1–7.1) years. Dietary GI, GL, II, and IL were calculated using a food frequency questionnaire at the baseline. Multivariate Cox proportional hazard regression models were used to estimate the risk of CVD across quartiles of dietary insulin and glycemic indices. Results Mean ± SD age of the subjects(44.9% men) was 38.3 ± 13.4 years. During a mean of 2406 ± 417 person-years of follow-up, 76(3.5%) new cases of the CVD were ascertained. The mean ± SD of II, IL, GI, and GL of participants were 51.7 ± 6.5, 235.8 ± 90.2, 61.9 ± 7.8, and 202.2 ± 78.1, respectively. After adjusting for the variables of age, sex, smoking, physical activity, daily energy intake, body mass index, diabetes, and hypertension, the hazard ratio (HR) of the highest quartile of dietary GL was 2.77(95%CI:1.00–7.69,P for trend:0.033) compared to the lowest one. Also, each one SD increase in the GL score was associated with a higher risk of CVD[(RR:1.46;CI:1.00–2.16),P-value = 0.047]. However, there was no significant association between the dietary GI, II, and IL and risk for CVD incidence. Conclusions Our results suggested that a high GL diet can increase the incidence of CVD, whereas high dietary II and IL were not associated with the risk of CVD among adults.

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Leucocyte Telomere Length and Risk of Cardiovascular Disease in a Cohort of 1,397 Danish Men and Women

Cardiology ◽

10.1159/000441819 ◽

2015 ◽

Vol 133 (3) ◽

pp. 173-177 ◽

Cited By ~ 13

Author(s):

Hanne Ellehoj ◽

Laila Bendix ◽

Merete Osler

Keyword(s):

Telomere Length ◽

Regression Models ◽

Proportional Hazard ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Men And Women ◽

Cox Proportional Hazard ◽

Increased Risk ◽

Cox Proportional Hazard Regression

Objectives: Short leucocyte telomere length (LTL) might be a risk factor for cardiovascular diseases (CVD). The present study examines the relation between LTL and incident fatal or non-fatal CVD, ischaemic heart disease (IHD) and stroke in a Danish cohort followed for 29 years. Methods: In total, 1,397 men and women who participated in health examinations with blood sampling in 1981-1984 were followed for CVD outcomes until the end of 2012 by linkage to national registers. Cox proportional hazard regression models were used to analyse the relation between LTL and CVD adjusting for potential confounding CVD risk factors. Results: During the follow-up, 603 participants experienced an incident fatal or non-fatal CVD. The survival analysis showed that baseline LTL was not associated with CVD outcomes. In the subanalysis with IHD as outcome, those with middle and short LTL had an increased hazard rate ratio of 1.97 (95% CI 1.31-2.93) and 1.55 (95% CI 1.02-2.35), respectively, which was attenuated when confounding factors were adjusted for. For stroke, the pattern of associations was similar but less precisely estimated. Conclusions: In this study short, LTL was not associated with an increased risk of CVD, but modestly associated with an increased risk of IHD.

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Factors Associated With Antiretroviral Therapy Reinitiation in Medicaid Recipients With Human Immunodeficiency Virus

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz666 ◽

2019 ◽

Vol 221 (10) ◽

pp. 1607-1611

Author(s):

T Zhang ◽

I B Wilson ◽

B Youn ◽

Y Lee ◽

T I Shireman

Keyword(s):

Antiretroviral Therapy ◽

Retrospective Cohort ◽

Patient Characteristics ◽

Proportional Hazard ◽

Factors Associated ◽

Cox Proportional Hazard ◽

Outpatient Visits ◽

Immunodeficiency Virus ◽

Cox Proportional Hazard Regression

Abstract Background This study was conducted to examine patient characteristics associated with antiretroviral therapy (ART) reinitiation in Medicaid enrollees. Methods This is a retrospective cohort study that uses Cox proportional hazard regression to examine the association between person-level characteristics and time from ART discontinuation to the subsequent reinitiation within 18 months. Results There were 45 409 patients who discontinued ART, and 44% failed to reinitiate. More outpatient visits (3+ vs 0 outpatient visits: adjusted hazard ratio (adjHR), 1.56; 99% confidence interval [CI], 1.45–1.67) and hospitalization (adjHR, 1.18; 99% CI,1.16–1.20) during follow-up were associated with reinitiation. Conclusions Failure to reinitiate ART within 18 months was common in this sample. Care engagement was associated with greater ART reinitiation.

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Association Between Preeclampsia Risk and Fine Air Pollutants and Acidic Gases: A Cohort Analysis in Taiwan

Frontiers in Public Health ◽

10.3389/fpubh.2021.617521 ◽

2021 ◽

Vol 9 ◽

Author(s):

Shih-Yi Lin ◽

Yu-Cih Yang ◽

Jun-Wei Su ◽

Jie-Sian Wang ◽

Chang-Cheng Jiang ◽

...

Keyword(s):

Cohort Analysis ◽

Air Pollutant ◽

Research Database ◽

Proportional Hazard ◽

Acidic Gases ◽

Cox Proportional Hazard ◽

Taiwan National Health Insurance ◽

Daily Concentration ◽

Cox Proportional Hazard Regression ◽

Combined Data

Background: Fine air pollutant particles have been reported to be associated with risk of preeclampsia. The association between air pollutant exposure and preeclampsia risk in heavily air polluted Taiwan warrants investigation.Methods: We combined data from Taiwan National Health Insurance (NHI) Research Database (NHIRD) and Taiwan Air Quality Monitoring Database. Women aged 16–55 years were followed from January 1, 2000, until appearance of ICD-9 coding of preeclampsia withdrawal from the NHI program, or December 31, 2013. Daily concentration of NOx, NO, NO2, and CO was calculated by Kriging method. The Cox proportional hazard regression model was used for risk assessment.Results: For NOx, Relative to Quartile [Q] 1 concentrations, the Q2 (adjusted hazard ratio adjusted = 2.20, 95% CI = 1.50–3.22), Q3 (aHR = 7.28, 95% CI = 4.78–11.0), and Q4 (aHR = 23.7, 95% CI = 13.7–41.1) concentrations were associated with a significantly higher preeclampsia or eclampsia risk. Similarly, for NO, relative to Q1 concentrations, the Q2 (aHR = 1.82, 95% CI = 1.26–2.63), Q3 (aHR = 7.53, 95% CI = 5.12–11.0), and Q4 (aHR = 11.1, 95% CI = 6.72–18.3) concentrations were correlated with significantly higher preeclampsia or eclampsia risk. Furthermore, for NO2, relative to Q1 concentration, the Q2 (aHR = 1.99, 95% CI = 1.37–2.90), Q3 (aHR = 6.15, 95% CI = 3.95–9.57), and Q4 (aHR = 32.7, 95% CI = 19.7–54.3) concentrations also associated with a significantly higher preeclampsia or eclampsia risk.Conclusion: Women exposed to higher NOX, NO, NO2, and CO concentrations demonstrated higher preeclampsia incidence.

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Increased risk of non-multiple sclerosis demyelinating syndromes in patients with preexisting septicaemia: a nationwide retrospective cohort study

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2019-136667 ◽

2019 ◽

Vol 95 (1124) ◽

pp. 307-313

Author(s):

Chung-Hsing Chou ◽

Jiunn-Tay Lee ◽

Chia-Kuang Tsai ◽

Li-Ming Lien ◽

Jiu-Haw Yin ◽

...

Keyword(s):

Multiple Sclerosis ◽

Epidemiological Data ◽

Population Based ◽

Research Database ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Increased Risk ◽

Cox Proportional Hazard Regression ◽

The Relationship

BackgroundGrowing evidence shows links between septicaemia and non-multiple sclerosis demyelinating syndromes (NMSDS); nevertheless, epidemiological data are still very limited. This study aimed to explore the relationship between septicaemia and NMSDS in a general population.MethodsThe study included 482 781 individuals diagnosed with septicaemia and 1 892 825 age/sex-matched non-septicaemia patients for the comparison. Data were drawn from a population-based nationwide National Health Insurance Research Database Taiwan, from 1 January 2002 to 31 December 2011. The two cohorts of patients with and without septicaemia were followed up for the occurrence of NMSDS. The Cox-proportional hazard regression model was performed to estimate adjusted HR after multivariate adjustment.ResultsIndividuals with septicaemia had a 4.17-fold (95% CI 3.21 to 5.4, p < 0.001) higher risk to develop NMSDS compared with those without septicaemia. Patients aged <65 years had a greater NMSDS risk (<45 years: HR = 6.41, 95% CI 3.65 to 11.3, p < 0.001; 45–64 years: HR = 6.66, 95% CI 3.98 to 11.2, p < 0.001). Furthermore, females with septicaemia and individuals with higher severity of septicaemia were associated with increased risks of developing NMSDS.ConclusionsOur results indicated that patients with septicaemia were likely to develop NMSDS. A possible contributing role of septicaemia in increasing the hazard of NMSDS is proposed, based on the outcome that individuals with higher severity of septicaemia carried elevated threat of encountering NMSDS.

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The elevated risk of sight-threatening cataract in diabetes with retinopathy: a cohort study

10.21203/rs.2.21037/v1 ◽

2020 ◽

Author(s):

Chan-Wei Nien ◽

Chia-Yi Lee ◽

Hung-Chi Chen ◽

Shih-Chun Chao ◽

Hung-Jui Hsu ◽

...

Keyword(s):

Cataract Surgery ◽

Multivariable Analysis ◽

Cumulative Probability ◽

Control Group ◽

Study Group ◽

Research Database ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

And Gender ◽

Cox Proportional Hazard Regression

Abstract Background To survey the effect of diabetic retinopathy (DR) on the development of sight-threatening cataract via National Health Insurance Research Database of Taiwan.Methods Patients diagnosed with diabetes mellitus (DM) and DR were enrolled in the study group. The age and gender-matched DM individuals without DR and patients without DM served as the DM control group and non-DM control group, both with 1:4 ratios. The outcome was set as the performance of cataract surgery. Cox proportional hazard regression was used to calculate the adjusted hazard ratio (aHR) of DR with considering multiple factors of cataract formation.Results A total of 3,297 DR patients, 13,188 DM control patients and 13,188 non-DM controls were enrolled. There were 919 events (27.87 percent) of sight-threatening cataract in the study group while another 1,108 events (8.40 percent) in the DM control group and 957 events (7.26 percent) in the non-DM control group. After multivariable analysis, the study group showed a higher aHR of cataract surgery (2.93, 95% CI: 2.60-3.30) and a higher cumulative probability of cataract surgery compared to both the DM control and non-DM control groups (both Log rank P<0.001). Besides, both the proliferative DR (3.90, 95% CI: 3.42-4.45) and non-proliferative DR (2.35, 95% CI: 2.08-2.65) subgroups showed a higher aHR of cataract surgery than the DM control group.Conclusion The presence of DR will increase the risk for development of sight-threatening cataract that surgery is warranted, and the effect is prominent in both the proliferative DR and non-proliferative DR.

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The cumulative dose-dependent effects of metformin on the development of tuberculosis in patients newly diagnosed with type 2 diabetes mellitus

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01667-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Eunyoung Heo ◽

Eunyoung Kim ◽

Eun Jin Jang ◽

Chang-Hoon Lee

Keyword(s):

Diabetes Mellitus ◽

Cumulative Dose ◽

Regression Models ◽

Proportional Hazard ◽

Newly Diagnosed ◽

Hazard Regression ◽

Cox Proportional Hazard ◽

Type 2 Dm ◽

Cox Proportional Hazard Regression

Abstract Background Diabetes mellitus (DM) is a well-known risk factor for tuberculosis (TB). Metformin, which is an essential anti-diabetic drug, has been shown to exhibit anti-TB effects in patients with DM. Its effect on preventing the development of TB among patients who are newly diagnosed with DM remains unclear. Methods This was a retrospective cohort study using the claims database of the Korean Health Insurance Review and Assessment Service. The study population included patients who were newly diagnosed with type 2 DM and who were treated with anti-diabetic drugs between 1 January 2003 and 31 March 2011. A patient was defined as a metformin user if he/she had taken metformin for more than 28 days within 6 months since cohort entry, and as a metformin non-user if he/she had never been treated with metformin. The development of TB within 2 years after the index date was compared by Cox proportional hazard regression models between metformin users and 1:1 propensity score (PS)-matched non-users. Results Among 76,973 patients who were newly diagnosed with type 2 DM, 13,396 were classified as metformin users, 52,736 were classified as metformin non-users, and 10,841 were excluded from the final analysis. PS-matched Cox proportional hazard regression models revealed that metformin use was not associated overall with the prevention of TB development (HR 1.17; 95% CI 0.75–1.83; P = 0.482). There was a trend, however, towards a reduction in the development of TB among patients taking a higher cumulative dose of metformin. Patients who were in the highest quartile (Q4) of cumulative metformin dose had only a 10% risk of developing TB compared to metformin non-users. In contrast, during the early phases of metformin treatment, patients in the second quartile (Q2) of cumulative metformin use had a higher risk of developing TB than patients in the first quartile (Q1). Conclusions Only the highest cumulative doses of metformin were protective against the development of TB among patients who were newly diagnosed with type 2 DM; lower cumulative doses of metformin did not appear to reduce the incidence of active TB infection.

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Association between Statin Use and Sepsis Risk in Patients with Dementia: A Retrospective Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16091626 ◽

2019 ◽

Vol 16 (9) ◽

pp. 1626 ◽

Cited By ~ 1

Author(s):

Liang-Tsai Yeh ◽

Chuan-Yi Tang ◽

Shun-Fa Yang ◽

Han-Wei Yeh ◽

Ying-Tung Yeh ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Positive Association ◽

Research Database ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Sepsis Risk ◽

Using Data ◽

Statin Use

This study investigated the association of statin use with sepsis risk in patients with dementia. This retrospective cohort study was conducted in Taiwan by using data from the National Health Insurance Research Database. We identified and enrolled 308 patients with newly diagnosed dementia who used statin after dementia diagnosis. These patients were individually propensity score matched (1:1) according to age, sex, hypertension, hyperlipidemia, diabetes, cerebrovascular disease, renal disease, liver disease, asthma, malignancy, parkinsonism, and dementia drugs used (donepezil, rivastigmine, galantamine, and memantine) with 251 controls (statin non-users). A Cox proportional hazard model was used to estimate the adjusted hazard ratio for sepsis in statin users and non-users. After adjustment for other confounding factors, the incidence of sepsis in statin users was 1.42-fold higher than that in non-users (95% confidence interval = 0.81–2.5). In conclusion, our analysis showed no positive association of sepsis with statin use in patients with dementia.

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Conjugated equine estrogen used in postmenopausal women associated with a higher risk of stroke than estradiol

Scientific Reports ◽

10.1038/s41598-021-90357-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Wei-Chuan Chang ◽

Jen-Hung Wang ◽

Dah-Ching Ding

Keyword(s):

Postmenopausal Women ◽

Population Based ◽

Research Database ◽

Proportional Hazard ◽

Conjugated Equine Estrogen ◽

Cox Proportional Hazard ◽

Hazard Ratios ◽

Taiwanese Women ◽

Taiwan National Health Insurance ◽

Cox Proportional Hazard Regression

AbstractThis study aimed to evaluate the risk of ischemic stroke (IS) in hormone therapy (HT) with oral conjugated equine estrogen (CEE) and estradiol (E2) in postmenopausal women in Taiwan. A retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database, a population-based healthcare claims dataset. Eligible women, aged 40–65 years, who received HT with E2 and CEE orally were enrolled. The primary outcome was IS. Propensity score matching with menopausal age and comorbidities was used. Cox proportional hazard regression models were used to calculate the incidence and hazard ratios (HRs) for IS. The mean menopausal ages of the E2 and CEE groups were 50.31 ± 4.99 and 50.45 ± 5.31 years, respectively. After adjusting for age and comorbidities, the incidence of IS was 1.17-fold higher in the women treated with CEE than in those treated with E2 (4.24 vs. 3.61/1000 person-years), with an adjusted HR (aHR) of 1.23 (95% confidence interval [CI] 1.05–1.44). Moreover, HT with CEE initiated within 5 years of menopause had a higher HR than E2 (aHR = 1.20; 95% CI 1.02–1.42). In conclusion, HT with oral CEE might be associated with a higher risk of IS than E2 in postmenopausal Taiwanese women. The use of HT with CEE should be cautioned with the risk of IS.

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