Maternal diet in pregnancy and child's respiratory outcomes: an individual participant data meta-analysis of 18 000 children

2021 ◽  
pp. 2101315
Author(s):  
Sara M. Mensink-Bout ◽  
Evelien R. van Meel ◽  
Johan C. de Jongste ◽  
Isabella Annesi-Maesano ◽  
Adrien M. Aubert ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Meta Analysis ◽  
Maternal Diet ◽  
Dash Score ◽  
Individual Participant Data ◽  
Z Score ◽  
Increased Risk ◽  
Individual Participant ◽  
Quality Diet ◽  
Respiratory Outcomes

RationaleSevere fetal malnutrition has been related to an increased risk of respiratory diseases later in life, but evidence for the association of a suboptimal diet during pregnancy with respiratory outcomes in childhood is conflicting. We aimed to examine whether a pro-inflammatory or low-quality maternal diet during pregnancy was associated with child's respiratory health.MethodsWe performed an individual participant meta-analysis among 18 326 mother-child pairs from seven European birth cohorts. Maternal pro-inflammatory and low-quality diet were estimated by energy-adjusted Dietary Inflammatory Index (E-DIITM) and Dietary Approaches to Stop Hypertension (DASH) scores. Preschool wheezing and school-age asthma were measured by questionnaires and lung function by spirometry.ResultsAfter adjustment for lifestyle and sociodemographic factors, we observed that a higher maternal E-DII score (a more pro-inflammatory diet) during pregnancy was associated only with a lower FVC in children (Z-score difference (95% confidence interval (CI)): −0.05 (−0.08, −0.02), per IQR increase). No linear associations of the maternal E-DII or DASH score with child's wheezing or asthma were observed. When exploratively examining the extremes, a very low DASH score (<10th percentile) (a very low dietary quality) was associated with an increased risk of preschool wheezing and a low FEV1/FVC (z-score <−1.64) (OR (95% CI) 1.20 (1.06, 1.36), 1.40 (1.06, 1.85), compared to ≥10th percentile), with corresponding population attributable risk fractions of 1.7% and 3.3%.ConclusionMain results from this individual participant data meta-analysis do not support the hypothesis that maternal pro-inflammatory or low-quality diet in pregnancy are related to respiratory diseases in childhood.

scholarly journals The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Rohan Borschmann ◽  
Holly Tibble ◽  
Matthew J Spittal ◽  
David Preen ◽  
Jane Pirkis ◽  
...  
Keyword(s):  
Mental Health Problems ◽  
Meta Analysis ◽  
Individual Participant Data ◽  
Physical And Mental Health ◽  
Relevant Evidence ◽  
Analysis Methodology ◽  
Increased Risk ◽  
Global Epidemiology ◽  
Individual Participant ◽  
Causes And Risk Factors

IntroductionMore than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance.   ObjectivesTo comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from prison. MethodsWe created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology. ResultsThe combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. ConclusionsThe consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalized population. Key wordsMortality; incarceration; prison; release; individual participant data meta-analysis; consortium; cohort.    

scholarly journals Sex-specific effects of nutritional supplements in infants born early or small: protocol for an individual participant data meta-analysis (ESSENCE IPD-MA)

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033438 ◽  
Author(s):  
Luling Lin ◽  
Caroline Crowther ◽  
Greg Gamble ◽  
Frank Bloomfield ◽  
Jane E Harding
Keyword(s):  
Meta Analysis ◽  
Ethics Committees ◽  
Postnatal Growth ◽  
High Energy ◽  
Adverse Outcomes ◽  
Individual Participant Data ◽  
Poor Growth ◽  
Intention To Treat ◽  
Increased Risk ◽  
Individual Participant

IntroductionPreterm and small for gestational age (SGA) infants are at increased risk of poor growth, disability and delayed development. While growing up they are also at increased risk of obesity, diabetes and later heart disease. The risk of such adverse outcomes may be altered by how preterm and SGA infants are fed after birth. Faltering postnatal growth is common due to failure to achieve recommended high energy and protein intakes, and thus preterm and SGA infants are often provided with supplemental nutrition soon after birth. Enhanced nutrition has been associated with improved early growth and better cognitive development. However, limited evidence suggests that faster growth may increase the risk for later adiposity, metabolic and cardiovascular disease, and that such risks may differ between girls and boys.Methods and analysisWe will search Ovid MEDLINE, Embase, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, controlled-trials.com, ClinicalTrials.gov and anzctr.org.au for randomised trials that studied the effects of macronutrient supplements for preterm and SGA infants on (i) developmental and metabolic and (ii) growth outcomes after hospital discharge. The outcomes will be (i) cognitive impairment and metabolic risk (co-primary) and (ii) body mass index. Individual participant data (IPD) from all available trials will be included using an intention-to-treat approach. A one-stage procedure for IPD meta-analysis (MA) will be used, accounting for clustering of participants within studies. Exploratory subgroup analyses will further investigate sources of heterogeneity, including sex and size of infants, different timing, duration and type of supplements.Ethics and disseminationThis IPD-MA is approved by the University of Auckland Human Participants Ethics Committee (reference number: 019874). Individual studies have approval from relevant local ethics committees. Results will be disseminated in a peer-reviewed journal and presented at international conferences.PROSPERO registration numberCRD42017072683

scholarly journals A systematic review of blood biomarkers with individual participant data meta-analysis of matrix-metalloproteinase-7 in IPF

2021 ◽  
pp. 2101612
Author(s):  
Fasihul A. Khan ◽  
Iain Stewart ◽  
Gauri Saini ◽  
Karen A. Robinson ◽  
R. Gisli Jenkins
Keyword(s):  
Systematic Review ◽  
Matrix Metalloproteinase ◽  
Disease Progression ◽  
Meta Analysis ◽  
Secondary Outcome ◽  
Individual Participant Data ◽  
Increased Risk ◽  
Matrix Metalloproteinase 7 ◽  
Individual Participant ◽  
Poor Outcomes

BackgroundBlood derived biomarkers have been extensively described as potential prognostic markers in idiopathic pulmonary fibrosis (IPF), but studies have been limited by analyses using data-dependent thresholds, inconsistent adjustment for confounders and an array of endpoints, thus often yielding ungeneralisable results. Meta-analysis of individual participant data (IPD) is a powerful tool to overcome these limitations. Through systematic review of blood derived biomarkers, sufficient studies with measurements of Matrix Metalloproteinase-7 (MMP-7) were identified to facilitate standardised analyses of the prognostic potential of this biomarker in IPF.MethodsElectronic databases were searched on 12th November 2020 to identify prospective studies reporting outcomes in patients with untreated IPF, stratified according to at least one pre-specified biomarker, measured at either baseline, or change over three months. Individual participant data (IPD) was sought for studies investigating MMP-7 as a prognostic factor. The primary outcome was overall mortality according to standardised MMP-7 z-scores, with a secondary outcome of disease progression in 12 months, all adjusted for age, gender, smoking and baseline FVC.ResultsIPD was available for nine studies out of twelve identified, reporting outcomes from 1664 participants. Baseline MMP-7 levels were associated with increased mortality risk (adjusted HR1.23, 95%CI 1.03;1.48, I2=64.3%) and disease progression (adjusted OR1.27, 95%CI 1.11;1.46, I2=5.9%). In limited studies, three-month change in MMP-7 was not associated with outcomes.ConclusionIPD meta-analysis demonstrated greater baseline MMP-7 levels were independently associated with an increased risk of poor outcomes in patients with untreated IPF, whilst short term changes did not reflect disease progression.

scholarly journals An individual participant data meta-analysis of prognostic blood biomarkers in IPF

2021 ◽  
Author(s):  
Fasihul A Khan ◽  
Iain Stewart ◽  
Gauri Saini ◽  
Karen A. Robinson ◽  
R Gisli Jenkins
Keyword(s):  
Disease Progression ◽  
Meta Analysis ◽  
Individual Participant Data ◽  
Blood Biomarkers ◽  
Disease Trajectory ◽  
Increased Risk ◽  
Matrix Metalloproteinase 7 ◽  
Individual Participant ◽  
Fibrotic Lung Disease ◽  
Overall Mortality

ABSTRACTBackgroundIdiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease with variable disease trajectory. Blood biomarkers reflecting disease severity that can accurately predict outcomes are urgently needed. Through systematic review and meta-analysis, we evaluate the prognostic potential of matrix-metalloproteinase-7 (MMP-7) and other frequently studied blood biomarkers in patients with IPF.MethodsElectronic databases were searched on 12th November 2020 to identify prospective studies reporting outcomes in patients with untreated IPF, stratified according to at least one pre-specified biomarker, measured at either baseline or change over three months. Individual participant data (IPD) was sought for studies investigating MMP-7 as a prognostic factor. The primary outcome was overall mortality, with secondary outcomes including disease progression, defined as >10% relative FVC decline or death.Results29 studies reporting outcomes from 3950 IPF participants were included, investigating a total of 16 biomarkers. IPD from MMP-7 studies was available for eleven cohorts. Baseline MMP-7 levels were associated with increased mortality (adjusted HR1.23 per SD increase, 95%CI 1.03;1.48, I2=64.3%) and disease progression (adjusted OR1.27 per SD increase, 95%CI 1.11;1.46, I2=5.9%), but change in MMP-7 over three-months was not associated with any of the measured outcomes. There was insufficient data for quantitative analysis in non-MMP7 studies, and whilst many biomarkers showed an association with clinical outcomes, replication of effects across studies was weak.ConclusionBaseline MMP-7 levels were associated with an increased risk of overall mortality and disease progression in patients with untreated IPF. The evidence for other biomarkers is currently insufficient with further studies needed.

scholarly journals Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts

F1000Research ◽  
2014 ◽  
Vol 2 ◽  
pp. 233 ◽  
Author(s):  
Ida E. H. Madsen ◽  
Harald Hannerz ◽  
Solja T. Nyberg ◽  
Linda L. Magnusson Hanson ◽  
Kirsi Ahola ◽  
...  
Keyword(s):  
Publication Bias ◽  
Study Protocol ◽  
Job Strain ◽  
Meta Analysis ◽  
Unipolar Depression ◽  
Hospital Treatment ◽  
Individual Participant Data ◽  
Risk Estimates ◽  
Increased Risk ◽  
Individual Participant

Background: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted “job strain”) are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field. Methods: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job strain is associated with an increased risk of clinically diagnosed unipolar depression based on hospital treatment registers.  The study will be based on data from approximately 120,000 individuals who participated in 14 studies on work environment and health in 4 European countries. The self-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled using random effects meta-analysis. Discussion: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled risk estimates will not be influenced by selective reporting and publication bias. However, the results of the planned study may only pertain to severe cases of unipolar depression, because of the outcome measure applied.

scholarly journals Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 233 ◽  
Author(s):  
◽  
Ida E. H. Madsen ◽  
Harald Hannerz ◽  
Solja T. Nyberg ◽  
Linda L. Magnusson Hanson ◽  
...  
Keyword(s):  
Publication Bias ◽  
Study Protocol ◽  
Job Strain ◽  
Meta Analysis ◽  
Unipolar Depression ◽  
Hospital Treatment ◽  
Individual Participant Data ◽  
Risk Estimates ◽  
Increased Risk ◽  
Individual Participant

Background: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted “job strain”) are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field.Methods: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job strain is associated with an increased risk of clinically diagnosed unipolar depression based on hospital treatment registers.  The study will be based on data from approximately 120,000 individuals who participated in 14 studies on work environment and health in 4 European countries. The self-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled using random effects meta-analysis.Discussion: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled risk estimates will not be influenced by selective reporting and publication bias. However, the results of the planned study may only pertain to severe cases of unipolar depression, because of the outcome measure applied.

scholarly journals Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data

2017 ◽  
Vol 47 (8) ◽  
pp. 1342-1356 ◽  
Author(s):  
I. E. H. Madsen ◽  
S. T. Nyberg ◽  
L. L. Magnusson Hanson ◽  
J. E. Ferrie ◽  
K. Ahola ◽  
...  
Keyword(s):  
Risk Factor ◽  
Depressive Symptoms ◽  
Job Strain ◽  
Meta Analysis ◽  
Clinical Depression ◽  
Individual Participant Data ◽  
Individual Level ◽  
Level Data ◽  
Increased Risk ◽  
Individual Participant

BackgroundAdverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression.MethodWe identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium. Summary estimates of the association were obtained using random-effects models. Individual-level data analyses were based on a pre-published study protocol.ResultsWe included six published studies with a total of 27 461 individuals and 914 incident cases of clinical depression. From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47–2.13] and unpublished datasets (RR = 1.27, 95% CI 1.04–1.55). Further individual participant analyses showed a similar association across sociodemographic subgroups and after excluding individuals with baseline somatic disease. The association was unchanged when excluding individuals with baseline depressive symptoms (RR = 1.25, 95% CI 0.94–1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR = 1.03, 95% CI 0.81–1.32).ConclusionsJob strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.

scholarly journals An Individual Participant Data Population Pharmacokinetic Meta-analysis of Drug-Drug Interactions between Lumefantrine and Commonly Used Antiretroviral Treatment

2020 ◽  
Vol 64 (5) ◽  
Author(s):  
Jose Francis ◽  
Karen I. Barnes ◽  
Lesley Workman ◽  
Tamara Kredo ◽  
Lasse S. Vestergaard ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Meta Analysis ◽  
Population Pharmacokinetic ◽  
Individual Participant Data ◽  
Recommended Treatment ◽  
Antituberculosis Treatment ◽  
Adult Participants ◽  
Increased Risk ◽  
Individual Participant ◽  
Nonpregnant Adult

ABSTRACT Treating malaria in HIV-coinfected individuals should consider potential drug-drug interactions. Artemether-lumefantrine is the most widely recommended treatment for uncomplicated malaria globally. Lumefantrine is metabolized by CYP3A4, an enzyme that commonly used antiretrovirals often induce or inhibit. A population pharmacokinetic meta-analysis was conducted using individual participant data from 10 studies with 6,100 lumefantrine concentrations from 793 nonpregnant adult participants (41% HIV-malaria-coinfected, 36% malaria-infected, 20% HIV-infected, and 3% healthy volunteers). Lumefantrine exposure increased 3.4-fold with coadministration of lopinavir-ritonavir-based antiretroviral therapy (ART), while it decreased by 47% with efavirenz-based ART and by 59% in the patients with rifampin-based antituberculosis treatment. Nevirapine- or dolutegravir-based ART and malaria or HIV infection were not associated with significant effects. Monte Carlo simulations showed that those on concomitant efavirenz or rifampin have 49% and 80% probability of day 7 concentrations <200 ng/ml, respectively, a threshold associated with an increased risk of treatment failure. The risk of achieving subtherapeutic concentrations increases with larger body weight. An extended 5-day and 6-day artemether-lumefantrine regimen is predicted to overcome these drug-drug interactions with efavirenz and rifampin, respectively.

scholarly journals Optimism in adults born preterm: Systematic review and individual-participant-data meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259463
Author(s):  
Rachel K. Robinson ◽  
Kati Heinonen ◽  
Polina Girchenko ◽  
Marius Lahti-Pulkkinen ◽  
Eero Kajantie ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Birth Weight ◽  
Parental Education ◽  
Very Low Birth Weight ◽  
Meta Analysis ◽  
Individual Participant Data ◽  
Z Score ◽  
Standard Deviation Increase ◽  
Life Orientation Test ◽  
Individual Participant

Aim Preterm birth(<37 gestational weeks) is associated with numerous adversities, however, data on positive developmental outcomes remain limited. We examined if preterm and term born(≥37 gestational weeks) adults differ in dispositional optimism/pessimism, a personality trait associated with health and wellbeing. We assessed if birth weight z-score, neurosensory impairments and parental education modified the outcome. Methods We systematically searched PubMed and Web of Science for cohort or case-control studies(born ≥ 1970) with data on gestational age and optimism/pessimism reported using the Life-Orientation-Test-Revised in adulthood(≥18 years). The three identified studies(Helsinki Study of Very Low Birth Weight Adults; Arvo Ylppö Longitudinal Study; Avon Longitudinal Study of Parents and Children) provided data for the two-step random-effects linear regression Individual-Participant-Data meta-analysis. Results Preterm and term borns did not differ on optimism(p = 0.76). Preterms scored higher on pessimism than term borns(Mean difference = 0.35, 95%Confidence Interval 0.36, 0.60, p = 0.007), although not after full adjustment. Preterm born participants, but not term born participants, with higher birth weight z-score, had higher optimism scores (0.30 raw score units per standard deviation increase, 95% CI 0.10, 0.49, p = 0.003); preterm vs term x birth weight z-score interaction p = 0.004). Conclusions Preterm and term born adults display similar optimism. In preterms, higher birth weight may foster developmental trajectories promoting more optimistic life orientations.

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