Discovery of an Association Between Influenza Infection Rates and the Incidences of Craniosynostosis in the United States: A Potentially Modifiable Risk Factor

FACE ◽  
2020 ◽  
Vol 1 (2) ◽  
pp. 97-104
Author(s):  
Erika Simmerman Mabes ◽  
Jason Moraczewski ◽  
Taylor Chishom ◽  
Kyle Dymanus ◽  
Daniel Linder ◽  
...  
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Risk Factor ◽  
Immune Activation ◽  
Influenza Infection ◽  
The United States ◽  
Mixed Effects ◽  
Maternal Immune Activation ◽  
Increased Risk ◽  
Influenza Case

Objective: Maternal immune activation secondary to influenza infection during critical periods of fetal development is a significant risk factor for neuropsychiatric and neurodevelopmental disorders. The association between influenza and craniosynostosis is not well documented. We investigate the association between the incidence of influenza infection and incidence of craniosynostosis in the United States. Materials and Methods: Retrospective population-based observational study spanning using the National Inpatient Sample Database, the United States Center for Disease Control and Prevention FluView databases, including infants born with craniosynostosis in the United States from 2004 to 2013 and monthly influenza incidence in the United States from 2003 to 2013. Mixed-effects logistic regression tested the association between 2 variables: national influenza incidences and rate of craniosynostosis. Odds ratios were calculated for the occurrence of craniosynostosis in relation to previous months’ flu incidence. E-values were calculated to evaluate unmeasured confounders. Results: Retrospective analysis performed on 45 356 newborns with craniosynostosis. Mixed-effects logistic regression revealed for each additional influenza case per 1000 people, the odds of craniosynostosis event occurring 6 months later increased by 3.4 (adjusted P = .009, OR = 3.444, CI = 1.756-6.754). For each additional influenza case per 1000 people, the odds of craniosynostosis event occurring 7 and 2 months later decreased by 3.8 and 6.1, respectively (OR = 0.262 and 0.165; adjusted P value = .007 and <.001). E-value for the association between influenza and craniosynostosis incidence 6 months later was 6.35. The E-values for the association between influenza and craniosynostosis incidences 7 months and 2 months later were 7.1 and 11.6. Conclusion: There is an increased risk for craniosynostosis with influenza occurring in third month of pregnancy. There are protective effects against craniosynostosis with influenza occurring in second and seventh months of pregnancy. To our knowledge, this is the first study demonstrating an association between the rate of influenza and craniosynostosis, suggesting a potentially important connection, though not necessarily causality, between maternal immune activation and craniosynostosis.

The Association Between Influenza Infection Rates and the Incidence of Orofacial Clefts in the United States

FACE ◽  
2020 ◽  
pp. 273250162097303
Author(s):  
Kyle Dymanus ◽  
Taylor Chishom ◽  
Jason Moraczewski ◽  
William Carroll ◽  
Maria Lima ◽  
...  
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Risk Factor ◽  
Influenza Infection ◽  
The United States ◽  
Modifiable Risk Factor ◽  
Protective Effects ◽  
Orofacial Clefts ◽  
Online Data ◽  
Increased Risk

Objective: To investigate seasonal variation of orofacial clefts (OC) and measure association between United States (U.S.) influenza incidences and OC development for the purpose of identifying a potential modifiable risk factor for pregnant women. Design: Retrospective population-based observational study from 2004 to 2013. Setting: National Inpatient Sample Database (NIS), Wide-ranging Online Data for Epidemiologic Research (WONDER) Database, and National Respiratory and Enteric Virus Surveillance System’s (NRVESS) FluView database. Patients: U.S.-born infants with OC from 2004 to 2013 and monthly influenza incidence from 2003 to 2013. Main outcome measures: Using logistic regression, monthly odds ratios (OR) of OC were derived using January as baseline. Mixed-effects logistic regression was utilized to test association between national influenza and OC incidences. Results: There were 58 270 U.S. babies born with OC from 2004 to 2013. September births had the highest OC association (OR = 1.094, 95% CI = 1.051-1.138, E-value = 1.41), followed by June. For each additional influenza case per 1000 people, odds of OC event occurring during the 2nd month of pregnancy, or 7 months before delivery, was increased by 2.7 (OR = 2.659, CI = 1.456-4.856, E-value = 4.76). Odds of OC event occurring was decreased at the 3rd month of pregnancy, or 6 months before delivery by 7.8 (OR = 0.129, 95% CI = 0.068-0.246, E-value = 14.99). Conclusion: September and June births have the highest OC association. There is increased risk for OC with influenza occurring at the 2nd pregnancy month. Conversely, there are protective effects against OC with influenza occurring at the 3rd pregnancy month. These findings demonstrate an association between influenza rate and OC, suggesting a connection between maternal immune activation (mIA) and OC. Although further research is needed to determine the definitive link between the use of flu vaccines and OC occurrence, as well as the mechanism behind mIA secondary to influenza infection impacting OC incidence, this study presents a modifiable risk factor that could decrease the potential for mIA causing OC.

scholarly journals Altitude and risk of sudden unexpected infant death in the United States

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Richard Johnston ◽  
Xiaohan Yan ◽  
Tatiana M. Anderson ◽  
Edwin A. Mitchell
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Infant Death ◽  
The United States ◽  
Sudden Infant ◽  
Data Set ◽  
Live Births ◽  
Sudden Unexpected Infant Death ◽  
Increased Risk ◽  
Unexpected Infant Death

AbstractThe effect of altitude on the risk of sudden infant death syndrome (SIDS) has been reported previously, but with conflicting findings. We aimed to examine whether the risk of sudden unexpected infant death (SUID) varies with altitude in the United States. Data from the Centers for Disease Control and Prevention (CDC)’s Cohort Linked Birth/Infant Death Data Set for births between 2005 and 2010 were examined. County of birth was used to estimate altitude. Logistic regression and Generalized Additive Model (GAM) were used, adjusting for year, mother’s race, Hispanic origin, marital status, age, education and smoking, father’s age and race, number of prenatal visits, plurality, live birth order, and infant’s sex, birthweight and gestation. There were 25,305,778 live births over the 6-year study period. The total number of deaths from SUID in this period were 23,673 (rate = 0.94/1000 live births). In the logistic regression model there was a small, but statistically significant, increased risk of SUID associated with birth at > 8000 feet compared with < 6000 feet (aOR = 1.93; 95% CI 1.00–3.71). The GAM showed a similar increased risk over 8000 feet, but this was not statistically significant. Only 9245 (0.037%) of mothers gave birth at > 8000 feet during the study period and 10 deaths (0.042%) were attributed to SUID. The number of SUID deaths at this altitude in the United States is very small (10 deaths in 6 years).

Diabetes mellitus, race, and the odds of high-grade prostate cancer in men diagnosed with prostate cancer in the United States.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 180-180 ◽  
Author(s):  
T. Mitin ◽  
M. Chen ◽  
B. J. Moran ◽  
D. E. Dosoretz ◽  
M. J. Katin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diabetes Mellitus ◽  
United States ◽  
Logistic Regression ◽  
African American ◽  
Risk Factor ◽  
The United States ◽  
High Grade ◽  
Newly Diagnosed ◽  
Independent Association

180 Background: African American (AA) men present more frequently with high-grade prostate cancer (PCa) and are also more likely to have diabetes mellitus (DM). We evaluated whether there is an independent association between DM and the risk of high-grade PCa in men diagnosed with PCa, adjusting for the known predictors of high-grade PCa including AA race. Methods: Between 1991 and 2009 15,377 men newly diagnosed with PCa and treated at 1 of 26 centers, were analyzed in 2 cohorts. Multivariable logistic regression was performed to evaluate whether a diagnosis of DM was associated with the odds of Gleason 7 or 8 to 10 PCa, adjusting for AA race, advancing age, PSA level, and DRE findings. Results: AA men (AOR, 1.87; 95% CI, 1.04-3.37, P=0.04) and non-AA men (AOR, 1.61; 95% CI, 1.34-1.93; P<0.001) with diabetes were more likely to have GS 8 to 10 versus GS 6 or less PCa, compared to non-diabetic men. AA as compared to non-AA race was not significantly associated with the odds of having GS 8 to 10 as compared to 6 or less PCa, both in men with a diagnosis of DM (AOR, 1.47; 95% CI, 0.87-2.50; P=0.15) and without DM (AOR, 1.27; 95% CI, 0.92-1.74, P=0.14). AA race, however (AOR, 1.37; 95% CI, 1.17-1.60, P<0.001), but not DM (AOR 1.09; 95% CI, 0.97-1.22, P=0.16), was associated with GS 7 versus 6 or less PCa. Conclusions: A diagnosis of DM is a risk factor for presenting with Gleason 8 to 10 PCa independent of race. [Table: see text] No significant financial relationships to disclose.

scholarly journals Outbreaks of Escherichia coli O157 infections at multiple county agricultural fairs: a hazard of mixing cattle, concession stands and children

2003 ◽  
Vol 131 (3) ◽  
pp. 1055-1062 ◽  
Author(s):  
JOHN A. CRUMP ◽  
CHRISTOPHER R. BRADEN ◽  
MEGHAN E. DEY ◽  
R. MICHAEL HOEKSTRA ◽  
JANET M. RICKELMAN-APISA ◽  
...  
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
Risk Factor ◽  
Distribution System ◽  
Proportional Hazards Model ◽  
The United States ◽  
E Coli ◽  
Summer Peak ◽  
Agricultural Fairs ◽  
Increased Risk

Escherichia coli O157 infections cause an estimated 60 deaths and 73000 illnesses annually in the United States. A marked summer peak in incidence is largely unexplained. We investigated an outbreak of E. coli O157 infections at an agricultural fair in Ohio and implicated consumption of beverages made with fairground water and sold by a geographically localized group of vendors who were all on the same branch of the fairground water distribution system. To examine county fair attendance as a risk factor for infection, we conducted two further epidemiological studies. In the first, we enhanced surveillance for E. coli O157 infections in 15 Northeast Ohio counties during the 2000 agricultural fair season and showed increased risk of E. coli O157 infection among fair attendees. In the second study, we examined Ohio Public Health Laboratory Information Service (PHLIS) data for 1999 using a time-varying covariate proportional hazards model and demonstrated an association between agricultural fairs and E. coli O157 infections, by county. Agricultural fair attendance is a risk factor for E. coli O157 infection in the United States and may contribute to the summer peak in incidence. Measures are needed to reduce transmission of enteric pathogens at agricultural fairs.

scholarly journals Principal Controversies in Vaccine Safety in the United States

2019 ◽  
Vol 69 (4) ◽  
pp. 726-731 ◽  
Author(s):  
Frank DeStefano ◽  
Heather Monk Bodenstab ◽  
Paul A Offit
Keyword(s):  
United States ◽  
Autoimmune Diseases ◽  
Influenza Infection ◽  
Vaccine Safety ◽  
The United States ◽  
Human Papillomavirus Vaccine ◽  
Vaccine Preventable Diseases ◽  
Developmental Problems ◽  
Epidemiologic Evidence ◽  
Increased Risk

Abstract Concerns about vaccine safety can lead to decreased acceptance of vaccines and resurgence of vaccine-preventable diseases. We summarize the key evidence on some of the main current vaccine safety controversies in the United States, including (1) measles, mumps, and rubella vaccine and autism; (2) thimerosal, a mercury-based vaccine preservative and the risk of neurodevelopmental disorders; (3) vaccine-induced Guillain-Barré syndrome (GBS); (4) vaccine-induced autoimmune diseases; (5) safety of human papillomavirus vaccine; (6) aluminum adjuvant-induced autoimmune diseases and other disorders; and (7) too many vaccines given early in life predisposing children to health and developmental problems. A possible small increased risk of GBS following influenza vaccination has been identified, but the magnitude of the increase is less than the risk of GBS following influenza infection. Otherwise, the biological and epidemiologic evidence does not support any of the reviewed vaccine safety concerns.

scholarly journals Household-acquisition of measles and illness severity in an urban community in the United States

1994 ◽  
Vol 112 (3) ◽  
pp. 569-577 ◽  
Author(s):  
J. C. Butler ◽  
M. E. Proctor ◽  
K. Fessler ◽  
D. J. Hopfensperger ◽  
D. M. Sosin ◽  
...  
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Risk Factor ◽  
Odds Ratio ◽  
The United States ◽  
Severe Illness ◽  
Multiple Logistic Regression ◽  
Hospitalization Rates ◽  
Vaccination History ◽  
Measles Vaccination

SUMMARYStudies from developing countries suggest that persons with household-acquired (HA) measles are at greater risk of severe illness than persons with community acquired (CA) infection. Reported measles cases occurring among Milwaukee residents from May 1989 to June 1990 were used to assess whether household acquisition was a risk factor for severe measles in the United States. A case was classified as HA if onset of rash occurred 7–18 days after onset of rash in another case in the same household. Hospitalization rates were similar for 128 patients with HA measles (27%) and for 1004 patients with CA measles (26%). Multiple logistic regression was used to evaluate the association between hospitalization and household-acquisition after controlling for socioeconomic status, measles vaccination history, age, race, and date of onset of rash. Patients with HA measles were no more likely to be hospitalized than patients with CA measles (odds ratio 0·9, 95% confidence interval 0·6, 1·5). HA measles cases were not more severe than CA measles cases during this urban outbreak in the United States.

scholarly journals Pregnancy outcomes after exposure to crisis pregnancy centers among an abortion-seeking sample recruited online

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255152
Author(s):  
Alice F. Cartwright ◽  
Katherine Tumlinson ◽  
Ushma D. Upadhyay
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Decision Support ◽  
Pregnancy Outcomes ◽  
The United States ◽  
Mixed Effects ◽  
Accurate Information ◽  
Lower Odds ◽  
Crisis Pregnancy

Introduction More than 2,500 crisis pregnancy centers (CPCs), which seek to convince people considering abortion to continue their pregnancies, exist in the United States. However, the characteristics of people who visit CPCs and their pregnancy outcomes are largely unknown. This study sought to describe the characteristics of people considering abortion who report visiting CPCs, and whether CPC visit is associated with abortion or continuing the pregnancy 4 weeks later. Methods Between August 2017 to May 2018, we recruited pregnant people searching for abortion services online, and 857 participants completed baseline and 4-week follow-up surveys. We described characteristics associated with visiting a CPC and compared pregnancy and abortion outcomes for those who reported CPC visit to those who did not using mixed-effects multivariable logistic regression. Results Overall, 13.1% of respondents visited a confirmed CPC. Living further away from a CPC was associated with lower odds of a CPC visit. At follow-up, respondents who had visited a CPC were significantly less likely to have had an abortion (29.5%) than those who had not visited a CPC (50.5%). In the adjusted models, respondents who had visited a CPC had higher odds of being pregnant and still seeking abortion (aOR: 2.26, 95% CI: 1.37–3.73) or continuing the pregnancy (aOR: 2.35, 95% CI: 1.33–4.15) (versus having had an abortion), than those who had not visited a CPC. Conclusions CPCs may be providing resources to people who are considering continuing their pregnancy and/or they may be misleading people about the care and referrals they provide related to abortion. Pregnant people need access to accurate information, decision support, and resources to make the pregnancy or abortion decision that is best for them.

scholarly journals Clotting events among hospitalized patients infected with COVID-19 in a large multisite cohort in the United States

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262352
Author(s):  
Sondra Maureen Nemetski ◽  
Andrew Ip ◽  
Joshua Josephs ◽  
Mira Hellmann
Keyword(s):  
United States ◽  
Venous Thrombosis ◽  
Influenza Infection ◽  
The United States ◽  
High Rate ◽  
Scientific Discussion ◽  
Time Period ◽  
Increased Risk ◽  
Infection Risk Factors ◽  
The Impact

Introduction COVID-19 infection has been hypothesized to precipitate venous and arterial clotting events more frequently than other illnesses. Materials and methods We demonstrate this increased risk of blood clots by comparing rates of venous and arterial clotting events in 4400 hospitalized COVID-19 patients in a large multisite clinical network in the United States examined from April through June of 2020, to patients hospitalized for non-COVID illness and influenza during the same time period and in 2019. Results We demonstrate that COVID-19 increases the risk of venous thrombosis by two-fold compared to the general inpatient population and compared to people with influenza infection. Arterial and venous thrombosis were both common occurrences among patients with COVID-19 infection. Risk factors for thrombosis included male gender, older age, and diabetes. Patients with venous or arterial thrombosis had high rates of admission to the ICU, re-admission to the hospital, and death. Conclusion Given the ongoing scientific discussion about the impact of clotting on COVID-19 disease progression, these results highlight the need to further elucidate the role of anticoagulation in COVID-19 patients, particularly outside the intensive care unit setting. Additionally, concerns regarding clotting and COVID-19 vaccines highlight the importance of addressing the alarmingly high rate of clotting events during actual COVID-19 infection when weighing the risks and benefits of vaccination.

Abstract 17223: Firefighting as an Independent Risk Factor for Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Catherine Vanchiere ◽  
Rithika Thirumal ◽  
Aditya D Hendrani ◽  
Parinita Dherange ◽  
Angela Bennett ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Air Pollution ◽  
Logistic Regression ◽  
Risk Factor ◽  
Occupational Exposures ◽  
The United States ◽  
Multivariate Logistic Regression ◽  
Unique Challenge ◽  
Increased Risk

Air pollution and particulate matter (PM) contribute to respiratory and cardiovascular disease over both chronic and acute exposure periods. Firefighters (FF) are a unique population which experiences these exposures, and likewise has a high risk of cardiovascular disease and death. The mechanisms by which air pollution and PM are proposed to cause disease are also known to contribute to development of arrhythmia, in particular atrial fibrillation (AF). The management of AF in FF is particularly challenging because the high likelihood of physical injury on the job makes anticoagulation more risky. In light of this unique challenge, we were interested in the risk of AF development in FF, and hypothesized that FF have an increased risk of AF. We distributed an electronic survey to FF via representative organizations to collect self-reported demographic, occupational, and clinical data. Multivariate logistic regression was used to assess the odds of having AF with participants stratified by the number of fires fought per year (≤ 10 vs ≥11). 11,965 firefighters completed the survey, of whom 93.53% were male and 96.31% were 65 years of age or younger. FF who fought ≥11 fires/year had a significantly higher lifetime prevalence of AF compared to FF who fought ≤10 fires/year (4.71% vs. 2.70%, p <0.001), and this relationship was seen to be dose-dependent (Figure 1). Multivariate logistic regression showed that, in addition to traditional risk determinants of AF like age, male sex, and hypertension, a higher number of fires fought per year (≥11) was independently associated with an increased risk of AF (OR 1.32, 95% CI 1.07 - 1.62, p =0.010).FF are a unique population with increased prevalence of AF, possibly related to occupational exposures. With over 1.1 million firefighters in the United States, it is imperative to conduct further research into the mechanisms behind this relationship, and to consider firefighting as a risk factor worthy of earlier screening and intervention.

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