ABSTRACT BACKGROUND Understanding the complex interaction of risk factors that increase the likelihood of developing common diseases is challenging. The Canadian Partnership for Tomorrow Project ...(CPTP) is a prospective cohort study created as a population-health research platform for assessing the effect of genetics, behaviour, family health history and environment (among other factors) on chronic diseases. METHODS Volunteer participants were recruited from the general Canadian population for a confederation of 5 regional cohorts. Participants were enrolled in the study and core information obtained using 2 approaches: attendance at a study assessment centre for all study measures (questionnaire, venous blood sample and physical measurements) or completion of the core questionnaire (online or paper), with later collection of other study measures where possible. Physical measurements included height, weight, percentage body fat and blood pressure. Participants consented to passive follow-up through linkage with administrative health databases and active follow-up through recontact. All participant data across the 5 regional cohorts were harmonized. RESULTS A total of 307 017 participants aged 30–74 from 8 provinces were recruited. More than half provided a venous blood sample and/or other biological sample, and 33% completed physical measurements. A total of 709 harmonized variables were created; almost 25% are available for all participants and 60% for at least 220 000 participants. INTERPRETATION Primary recruitment for the CPTP is complete, and data and biosamples are available to Canadian and international researchers through a data-access process. The CPTP will support research into how modifiable risk factors, genetics and the environment interact to affect the development of cancer and other chronic diseases, ultimately contributing evidence to reduce the global burden of chronic disease.
Abstract Background The incidence of preeclampsia is increasing, but effects on women and infants are unclear. We measured the incidence of preeclampsia over time in a large Canadian population, and ...assessed trends in maternal and infant morbidity and mortality. Methods We carried out a population-based study of 1,901,376 linked hospital discharge abstracts for all deliveries in the province of Quebec, Canada from 1989 through 2012. We computed the annual incidence of preeclampsia, and used log binomial models to determine associations with severe morbidity and mortality for preeclamptic vs nonpreeclamptic pregnancies. Main outcomes included maternal, fetal, and infant mortality, admission to intensive care, intubation, preterm delivery, growth restriction, cesarean delivery, transfusion, and severe medical complications. Results The incidence of preeclampsia increased from 26.4 per 1000 deliveries in 1989 to 50.6 in 2012. Maternal, fetal, and infant mortality decreased with time for preeclamptic but not for nonpreeclamptic pregnancies. By 2007-2012, risk for women with preeclampsia had declined for most maternal morbidities, except acute renal failure, which increased relative to no preeclampsia (risk ratio, 21.5; 95% confidence interval, 16.9-27.3). Risk of infant morbidity also decreased, but this coincided with an increase in the excess number of intubations and admissions for intensive care for preeclampsia relative to no preeclampsia. Conclusions The incidence of preeclampsia increased during the study, but with little effect on the risk of maternal and infant morbidity and mortality. For most outcomes, the risk decreased relative to no preeclampsia, with more aggressive medical management over time.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Objective The objective of the study was to examine the associations of maternal plasma levels of 25-hydroxyvitamin D 25(OH)D with angiogenesis and endothelial dysfunction indicators: soluble ...fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), intercellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1), and risk of preeclampsia. Study Design In this prospective cohort study (n = 697), maternal plasma 25(OH)D levels were measured at 12-18 and 24-26 weeks; sFlt-1, PlGF, ICAM-1, and VCAM-1 levels were measured at 24-26 weeks. Results Maternal PlGF levels were significantly lower in women with 25(OH)D less than 50 nmol/L at 12-18 weeks (median, 449.5 vs 507.9 pg/mL, P = 0.04) and 24-26 weeks (median, 450.4 vs 522.5 pg/mL, P = 0.007). Both maternal 25(OH)D and PlGF levels were inversely associated with the risk of preeclampsia (both P < .05). However, based on a test of interaction, there was no evidence that the association between vitamin D and preeclampsia depended on the level of PlGF. Conclusion Maternal vitamin D deficiency is associated with low PlGF levels and increased preeclampsia risk. However, our data do not support the hypothesis that the association between vitamin D deficiency and preeclampsia is mediated by impaired angiogenesis.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
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