scholarly journals Maternal Exposure to Disinfection By-Products and Risk of Hypospadias in the National Birth Defects Prevention Study (2000–2005)

2020 ◽  
Vol 17 (24) ◽  
pp. 9564
Author(s):  
Ibrahim Zaganjor ◽  
Thomas Luben ◽  
Tania Desrosiers ◽  
Alexander Keil ◽  
Lawrence Engel ◽  
...  
Keyword(s):  
Water Use ◽  
Birth Defects ◽  
The United States ◽  
Maternal Exposure ◽  
Individual Species ◽  
Prevention Study ◽  
Individual Level ◽  
Increased Risk ◽  
Using Data ◽  
By Products

The purpose of this study was to estimate the association between 2nd and 3rd degree hypospadias and maternal exposure to disinfection by-products (DBPs) using data from a large case-control study in the United States. Concentration estimates for total trihalomethanes (TTHMs), the sum of the five most prevalent haloacetic acids (HAA5), and individual species of each were integrated with data on maternal behaviors related to water-use from the National Birth Defects Prevention Study (NBDPS) to create three different exposure metrics: (1) household DBP concentrations; (2) estimates of DBP ingestion; (3) predicted uptake (i.e., internal dose) of trihalomethanes (THMs) via ingestion, showering, and bathing. The distribution of DBP exposure was categorized as follows: (Q1/referent) < 50%; (Q2) ≥ 50% to < 75%; and (Q3) ≥ 75%. Logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Generally, null associations were observed with increasing TTHM or HAA5 exposure. An increased risk was observed among women with household bromodichloromethane levels in the second quantile (aOR: 1.8; 95% CI: 1.2, 2.7); however, this association did not persist after the inclusion of individual-level water-use data. Findings from the present study do not support the hypothesis that maternal DBP exposures are related to the occurrence of hypospadias.

scholarly journals Association between Six Environmental Chemicals and Lung Cancer Incidence in the United States

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Juhua Luo ◽  
Michael Hendryx ◽  
Alan Ducatman
Keyword(s):  
Lung Cancer ◽  
Cancer Incidence ◽  
Environmental Science ◽  
The United States ◽  
Environmental Chemicals ◽  
Lung Cancer Incidence ◽  
Industrial Chemicals ◽  
Individual Level ◽  
Increased Risk ◽  
Seer Data

Background.An increased risk of lung cancer has been observed at exposure to certain industrial chemicals in occupational settings; however, less is known about their carcinogenic potential to the general population when those agents are released into the environment.Methods.We used the Toxics Release Inventory (TRI) database and Surveillance, Epidemiology, and End Results (SEER) data to conduct an ecological study at the county level. We used multiple linear regression to assess the association of age-adjusted lung cancer incidence with the quantities of on-site air and water releases of six selected industrial chemicals including arsenic, 1,3 butadiene, cadmium, chromium, formaldehyde, and nickel after controlling for other risk variables.Results.Overall, we observed a significantly increased risk of lung cancer incidence associated with releases of chromium, formaldehyde, and nickel. The links were present for both males and females. Significant effects were present in nonmetropolitan but not metropolitan counties. Releases of arsenic, 1,3 butadiene, and cadmium were reported by small numbers of facilities, and no relationships to lung cancer incidence were detected.Conclusions.Our results suggest that environmental exposure to chromium, formaldehyde, and nickel from TRI sites may increase population risk of lung cancer. These findings need to be confirmed in individual-level studies, but in congruence with the precautionary principle in environmental science, support prudent efforts to limit release of these agents into the environment.

scholarly journals 74. Maternal Dolutegravir (DTG) Use During Pregnancy and Birth Outcomes: The Antiretroviral Pregnancy Registry (APR)

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S48-S49
Author(s):  
Vani Vannappagari ◽  
Jessica Albano ◽  
Leigh Ragone ◽  
Taylor Cook ◽  
Angela Scheuerle ◽  
...  
Keyword(s):  
Birth Defects ◽  
Descriptive Analysis ◽  
The United States ◽  
Neonatal Outcomes ◽  
Congenital Defects ◽  
Think Tank ◽  
Research Support ◽  
Independent Contractor ◽  
Live Births ◽  
Increased Risk

Abstract Background The APR is prospective exposure-registration cohort study, monitoring for early warning signals of major teratogenic effects of antiretrovirals (ARV) used during pregnancy. This analysis aimed to assess maternal demographics, pregnancy and neonatal outcomes including birth defects among infants with periconception and prenatal exposure to DTG using APR data. Methods Descriptive analysis with frequency tabulation of pregnancy and neonatal outcomes is reported. Periconception is defined as any exposure within two weeks prior to or through 28 days after conception. Results There were 1010 prospectively reported pregnancies with exposure to DTG through 31January2021, with 526 periconception exposures, 105 exposed later during 1st trimester, 260 during 2nd trimester and 119 during 3rd trimester. Maternal median age at conception was 30 years and 77.0% of pregnancies were reported from the United States. At the time of reporting, 46.6% had CD4 count ≥500 cells/µL, 31.8% had 200-499 cells/µL, 12.5% had &lt; 200 cells/µL and 9.1% unknown. The 1010 DTG exposed pregnancies resulted in 1036 outcomes: 956 (92.3%) live births (26 twin pairs), 12 (1.2%) stillbirths, 28 (2.7%) induced abortions, and 38 (3.7%) spontaneous abortions. Among live births, 39 (4.1%) reported birth defects. For 1st trimester exposures, overall defect prevalence was 3.3% (19/576, 95% CI:2.0-5.1) and for 2nd/3rd trimester exposures defect prevalence was 5.3% (20/380, 95% CI:3.2-8.0). One neural tube defect (NTD) case of anencephaly with periconception DTG exposure was reported. Among the 873 singleton, live births without birth defects, 92 (10.5%) were preterm (&lt; 37 weeks of gestation); 103 (11.8%) had low birth weight (lbw) &lt; 2500 grams including 22 (2.5%) &lt; 1500 (very lbw) grams. Conclusion APR data do not demonstrate an increased risk of overall birth defects with DTG use above the population expected rate of defects (2.72 to 4.17 per 100 live births from Metropolitan Atlanta Congenital Defects Program [MACDP] and Texas Birth Defects Registry [TBDR] respectively). The number of periconception exposure outcomes is not yet sufficient to evaluate potential association of DTG with NTD. The Registry continues to closely monitor birth defects, including NTDs in pregnancies exposed to DTG and other integrase inhibitors. Disclosures Vani Vannappagari, MBBS, MPH, PhD, ViiV Healthcare Limited (Employee) Jessica Albano, PhD, MPH, Syneos Health (Employee, Shareholder) Leigh Ragone, MS, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee) Taylor Cook, BS, Syneos Health (Employee) Angela Scheuerle, MD, ViiV (Independent Contractor) William R. Short, MD, Gilead Sciences (Individual(s) Involved: Self): Consultant; ViiV (Individual(s) Involved: Self): Consultant Claire Thorne, MSc, PhD, MSD (Grant/Research Support)ViiV Healthcare (Grant/Research Support, Other Financial or Material Support, Contributor to Think Tank)

scholarly journals COVID-19 in Children with Down Syndrome: Data from the Trisomy 21 Research Society Survey

2021 ◽  
Vol 10 (21) ◽  
pp. 5125
Author(s):  
David Emes ◽  
Anke Hüls ◽  
Nicole Baumer ◽  
Mara Dierssen ◽  
Shiela Puri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Significant Risk ◽  
The United States ◽  
Research Society ◽  
Medical Complications ◽  
Thyroid Disorder ◽  
Increased Risk ◽  
Using Data ◽  
And Control

Adults with Down Syndrome (DS) are at higher risk for severe outcomes of coronavirus disease 2019 (COVID-19) than the general population, but evidence is required to understand the risks for children with DS, which is necessary to inform COVID-19 shielding advice and vaccination priorities. We aimed to determine the epidemiological and clinical characteristics of COVID-19 in children with DS. Using data from an international survey obtained from a range of countries and control data from the United States, we compared the prevalence of symptoms and medical complications and risk factors for severe outcomes between DS and non-DS paediatric populations with COVID-19. Hospitalised COVID-19 patients <18 years with DS had a higher incidence of respiratory symptoms, fever, and several medical complications from COVID-19 than control patients without DS <18 years. Older age, obesity, and epilepsy were significant risk factors for hospitalisation among paediatric COVID-19 patients with DS, and age and thyroid disorder were significant risk factors for acute respiratory distress syndrome. Mortality rates were low in all paediatric COVID-19 patients (with and without DS), contrasting with previous findings in adults with DS (who exhibit higher mortality than those without DS). Children with DS are at increased risk for more severe presentations of COVID-19. Efforts should be made to ensure the comprehensive and early detection of COVID-19 in this population and to identify children with DS who present comorbidities that pose a risk for a severe course of COVID-19. Our results emphasize the importance of vaccinating children with DS as soon as they become eligible.

scholarly journals Factors Associated with an Unmet Need for Contraception in the United States, 2002-2017

2019 ◽  
Author(s):  
Joseph Molitoris
Keyword(s):  
United States ◽  
Unwanted Pregnancy ◽  
Unmet Need ◽  
The United States ◽  
Modern Method ◽  
Sexually Active ◽  
Logistic Regression Models ◽  
Individual Level ◽  
Using Data ◽  
Unmet Need For Contraception

This study investigates the association between individual-level characteristics and the risk of having an unmet need for contraception in the United States between 2002 and 2017 for women who were sexually active, not pregnant or postpartum, fecund, and wanted no more children. Using data from the National Survey of Family Growth, logistic regression models are used to estimate the association between demographic, socioeconomic, and reproductive characteristics and the probability of having an unmet need for any contraception and for modern methods. The results show that 6.8% of the women at risk did not use any form of contraception and 12.1% did not use any modern method. Women who were black, Catholic, insured by Medicaid or uninsured, nulliparous, and who had not used contraception at their first sex had the greatest odds of having an unmet need, suggesting that specific groups are disproportionately vulnerable to unwanted pregnancy in the United States.

Birth Defects in Twins: Study in a Spanish Population

1991 ◽  
Vol 40 (3-4) ◽  
pp. 337-344 ◽  
Author(s):  
M.A. Ramos-Arroyo
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Birth Defects ◽  
Congenital Malformations ◽  
Collaborative Study ◽  
Congenital Defects ◽  
Relative Risks ◽  
Increased Risk ◽  
The Central Nervous System ◽  
Using Data

AbstractThe risk for specific defects among twins compared to singletons was studied using data collected by the Spanish Collaborative Study of Congenital Malformations (ECEMC). A total of 136 twins had a major and/or minor congenital defect. The overall rate of congenital defects in twins (2.37%) did not deviate significantly from the rate in singletons (2.21%). Like-sex (LS) and male-male (MM) twin pairs had a slightly higher rate of birth defects than unlike-sex (US) and female-female (FF) pairs, respectively. Defects of the central nervous system, cardiovascular system and genitourinary system were significantly more frequent in LS twins than in singletons, with relative risks of 2.8, 2.5 and 1.6, respectively. No significantly increased risk was found among US twins. Among defects of the central nervous system, the rates of anencephaly, encephalocele and hydrocephaly were significantly higher in total and LS twins; however, no significantly increased risk for spina bifida was observed when compared to singletons. MM twins were also 1.9 times more likely to have hypospadias, but the risk among males of male-female (FM) pairs was decreased.

scholarly journals Assessing bottled water nitrate concentrations to evaluate total drinking water nitrate exposure and risk of birth defects

2014 ◽  
Vol 12 (4) ◽  
pp. 755-762 ◽  
Author(s):  
Peter J. Weyer ◽  
Jean D. Brender ◽  
Paul A. Romitti ◽  
Jiji R. Kantamneni ◽  
David Crawford ◽  
...  
Keyword(s):  
Drinking Water ◽  
Water Use ◽  
Birth Defects ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Heart Defects ◽  
Maternal Exposure ◽  
Bottled Water ◽  
Nitrate Concentrations ◽  
Limb Deficiencies

Previous epidemiologic studies of maternal exposure to drinking water nitrate did not account for bottled water consumption. The objective of this National Birth Defects Prevention Study (NBDPS) (USA) analysis was to assess the impact of bottled water use on the relation between maternal exposure to drinking water nitrate and selected birth defects in infants born during 1997–2005. Prenatal residences of 1,410 mothers reporting exclusive bottled water use were geocoded and mapped; 326 bottled water samples were collected and analyzed using Environmental Protection Agency Method 300.0. Median bottled water nitrate concentrations were assigned by community; mothers' overall intake of nitrate in mg/day from drinking water was calculated. Odds ratios for neural tube defects, limb deficiencies, oral cleft defects, and heart defects were estimated using mixed-effects models for logistic regression. Odds ratios (95% CIs) for the highest exposure group in offspring of mothers reporting exclusive use of bottled water were: neural tube defects [1.42 (0.51, 3.99)], limb deficiencies [1.86 (0.51, 6.80)], oral clefts [1.43 (0.61, 3.31)], and heart defects [2.13, (0.87, 5.17)]. Bottled water nitrate had no appreciable impact on risk for birth defects in the NBDPS.

scholarly journals Disentangling Race, Poverty, and Place in Disparities in Physical Activity

2019 ◽  
Vol 16 (7) ◽  
pp. 1193 ◽  
Author(s):  
Armani Hawes ◽  
Genee Smith ◽  
Emma McGinty ◽  
Caryn Bell ◽  
Kelly Bower ◽  
...  
Keyword(s):  
Physical Activity ◽  
United States ◽  
Social Context ◽  
Racial Disparities ◽  
The United States ◽  
Future Research ◽  
Physically Active ◽  
Individual Level ◽  
Using Data ◽  
The Impact

Significant racial disparities in physical activity—a key protective health factor against obesity and cardiovascular disease—exist in the United States. Using data from the 1999–2004 National Health and Nutrition Examination Survey and the 2000 United States (US) Census, we estimated the impact of race, individual-level poverty, neighborhood-level poverty, and neighborhood racial composition on the odds of being physically active for 19,678 adults. Compared to whites, blacks had lower odds of being physically active. Individual poverty and neighborhood poverty were associated with decreased odds of being physically active among both whites and blacks. These findings underscore the importance of social context in understanding racial disparities in physical activity and suggest the need for future research to determine specific elements of the social context that drive disparities.

scholarly journals Exploring Differences in the Rate of Type 2 Diabetes Among American Cities: How Urbanization Continues to Challenge the Traditional Epidemiological View

Urban Science ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. 53
Author(s):  
Barry P. Young
Keyword(s):  
Type 2 Diabetes ◽  
Urban Areas ◽  
Disease Onset ◽  
The United States ◽  
Local Data ◽  
Medical Practitioners ◽  
Increased Risk ◽  
Control And Prevention ◽  
Using Data

As the world’s largest urban regions continue to expand, a concomitant rise in non-communicable diseases, particularly type 2 diabetes, poses an increasingly ominous challenge to experts in the field of public health. Given that the majority of the world’s population (54%) resides in urban areas, a figure likely to reach two-thirds by 2050, this issue presents serious implications for medical practitioners as well as policymakers seeking to manage long-term healthcare costs while sustaining historic increases in life expectancy. To explore how these trends are continuing to affect the United States, a multiple regression analysis was conducted using data provided by the Centers for Disease Control and Prevention (CDC) through their initiative, 500 Cities: Local Data for Better Health. The regression models revealed that larger cities reported significantly higher rates of type 2 diabetes even after controlling for variables that have been perennially linked to disease onset (e.g., levels of obesity, sedentary behavior). Implications are discussed, most notably the argument for moving beyond the ‘food desert’ paradigm when identifying and explaining which characteristics of larger cities place their residents at increased risk. This approach could help reveal opportunities for intervention that may not have garnered sufficient attention in the extant literature.

Structural Congenital Defects in Multiple Births

1994 ◽  
Vol 43 (1-2) ◽  
pp. 57-70 ◽  
Author(s):  
P. Mastroiacovo ◽  
L. Botto
Keyword(s):  
Birth Defects ◽  
Conjoined Twins ◽  
Morbidity And Mortality ◽  
Multiple Births ◽  
Structural Defects ◽  
Congenital Defects ◽  
Age Group ◽  
Pediatric Age Group ◽  
Increased Risk ◽  
Using Data

The prevalence of twinning and higher order multiple births is high and is increasing in many countries, due at least in part to fertility-enhancing medical therapies. About 1 in 40-45 births is a twin; it is thus important to investigate whether the twinning status confers a higher risk for morbidity and mortality, particularly early in life. Birth defects are a major cause of morbidity and mortality in the pediatric age-group. The purpose of this review is to consider the evidence for an increased risk of some birth defects associated with twinning, using data from the literature and the Italian Multicentre Birth Defects Registry (IPIMC), to illustrate some of the challenging aspects of the study of birth defects in twins, and to suggest some guidelines for future investigations.Twins are a heterogeneous group. They may differ in origin and genetic similarity, as for monozygotic (MZ) and dizygotic (DZ) twins; and in placentation (monochorial monoamniotic, monochorial diamniotic, dichorial with separate or fused placentae). Likewise, birth defects are known to be heterogeneous in presentation, pathogenesis, and etiology. Thus, the question raised here is not whether or not birth defects ‘in general’ are more common in twins, but rather whether or not there are any specific types of defects that are more frequent among specific types of twins. To maintain the generality of the discussion, this review will focus on those structural defects which are not unique to twins; conjoined twins and arcadia, defects which are unique to the twinning process, will not be discussed.

scholarly journals Persistent Disability Six Months after Initial Disability Less Likely in Older Women

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 880-881
Author(s):  
Raj Shah ◽  
Katherine Webb ◽  
Joanne Ryan ◽  
Rory Wolfe ◽  
Michael Ernst ◽  
...  
Keyword(s):  
Older Women ◽  
Proportional Hazards ◽  
The Elderly ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Increased Risk ◽  
Adl Disability ◽  
Using Data ◽  
Persistent Disability

Abstract Many community-dwelling older adults develop activity of daily living (ADL) disability and subsequently regain function. Using data from the ASPirin in Reducing Events in the Elderly (ASPREE) clinical trial, we examined the relationship of gender, incident disability, and persistent disability 6 months after the incident disability. Walking, bathing, dressing, transferring, toileting, and eating were assessed as ADLs, at bi-annual interviews. ADL disability was defined as requiring help with or inability to do or severe difficulty with ≥1 ADL; persistent disability was an ADL loss at 6 months after a first (incident) ADL disability. Discrete time, multivariable Cox proportional hazards regression was utilized to estimate associations with developing incident ADL disability described as cause-specific hazard ratios, with death as a competing outcome. For persons with incident ADL disability, odds of developing persistent disability at 6 months as compared to recovery was determined using multivariable logistic regression. These analyses included 18,414 (51.6% women) ASPREE participants in the United States and Australia aged 70+ years (65+ years if U.S. ethnic minority) without ADL disability at trial entry. During a median follow-up of 4.7 years, 1,485 participants (63.2% women) developed an incident ADL disability, and, of those, 272 (57.0% women) met criteria for persistent disability at 6 months. Women had an increased risk (HR=1.17, 95% CI=1.05 to 1.32) of developing incident ADL disability; however, women were less likely to have persistent disability versus recovery 6 months later (OR=0.66, 95% CI=0.49 to 0.89). Why persistent disability development is lower in older women needs further exploration.

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