Background High pre-pregnancy body mass index (BMI) and excessive gestational weight gain (GWG) are suggested to influence risk of asthma and atopic disease in offspring. Objective We examined the ...effect of BMI and GWG on risk of asthma, wheezing, atopic eczema (AE), and hay fever in children during the first 7 years of life. Methods This was a cohort study of 38,874 mother-child pairs from the Danish National Birth Cohort (enrollment 1996-2002) with information from the 16th week of pregnancy and at age 6 months, 18 months, and 7 years of the child. Odds ratios (ORs) with 95% CIs were calculated by logistic regression with adjustment for potential confounders. Results During the first 7 years of life, 10.4% of children developed doctor-diagnosed asthma, 25.8% AE, and 4.6% hay fever. Maternal BMI and to a lesser extent GWG were associated with doctor-diagnosed asthma ever. In particular, BMI ≥ 35 (adjusted OR, 1.87; 95% CI, 0.95-3.68) and GWG ≥ 25 kg (adjusted OR, 1.97; 95% CI, 1.38-2.83) were associated with current severe asthma at age 7 years. Maternal BMI was also associated with wheezing in offspring, with the strongest association observed between BMI ≥ 35 and late-onset wheezing (adjusted OR, 1.87; 95% CI, 1.28-2.73). Maternal BMI and GWG were not associated with AE or hay fever. Conclusions Maternal obesity during pregnancy was associated with increased risk of asthma and wheezing in offspring but not with AE and hay fever, suggesting that pathways may be nonallergic.
Objective We assessed whether preeclampsia correlates with the long-term postnatal health of the offspring. Study Design We conducted a population-based cohort study of 1,618,481 singletons born in ...Denmark (1978-2004) with up to 27 years of follow-up. We used Cox regression to estimate the associations between preeclampsia and long-term health outcomes of the offspring. Results Children born at term exposed to preeclampsia had an increased risk of a variety of diseases, such as endocrine, nutritional, and metabolic diseases (incidence rate ratio, 1.6; 95% confidence interval, 1.5–1.7), and diseases of the blood and blood-forming organs (incidence rate ratio, 1.5; 95% confidence interval, 1.3–1.8). Children born preterm exposed to preeclampsia had a similar pattern of hospitalizations compared with the children born preterm unexposed to preeclampsia, although they had a decreased risk of cerebral palsy (incidence rate ratio, 0.7; 95% confidence interval, 0.6–0.9). Conclusion Preeclampsia was associated with an increased risk of being hospitalized for a number of diseases, especially in the children born at term.
Purpose Preterm birth (PTB) has been associated with a later increased risk of maternal cardiovascular disease (CVD). We hypothesized a more pronounced relation between early or recurrent PTB and ...maternal CVD risk. Methods We related PTB severity (earlier gestational age at delivery) and recurrence (≥2) among women with births from 1973–1983 in Denmark ( n = 427,765) to maternal CVD morbidity or mortality (1977–2006). Birth data were linked to CVD hospitalizations and deaths identified in national registers and data were analyzed using Cox proportional hazards models. Results Women with a prior PTB had excess CVD after adjustment for age, parity, and education (hazard ratio HR = 1.36 95% confidence interval (CI): 1.31, 1.41). This was only modestly attenuated when women with preeclampsia or small for gestational age births were excluded, and the relationship was stronger for CVD mortality (HR = 1.98 1.73, 2.26). Recurrent PTB was associated with higher CVD morbidity compared to women with one PTB, particularly for ischemic events (HR = 1.78 1.40, 2.27 vs. 1.22 1.09, 1.36). Risk was similarly elevated among women with early, moderate, and late PTB. Sensitivity analysis suggested that confounding by smoking only partly explained these associations. Conclusions Women with PTB, especially recurrent PTB, were at increased risk for CVD, suggesting common causes of these conditions.
Objective We previously reported associations between preeclampsia and the occurrence of metabolic and respiratory diseases in the offspring. In this article we examine whether the associations were ...due to preeclampsia or factors leading to preeclampsia. Study Design From 1978 through 2004, we identified 22,264 discordant sib-pairs in Denmark according to prenatal exposure to preeclampsia. Exposed children were compared to their unexposed siblings by using stratified Cox regression to estimate hazard ratios and 95% confidence intervals for metabolic and respiratory diseases. Results Exposed children had rather similar risks for metabolic disorders compared to their unexposed siblings. However, when the second child within each sib-pair was exposed, this child had an increased risk for respiratory diseases (hazard ratio, 1.55; 95% confidence interval, 1.20–2.01). Conclusion Factors leading to preeclampsia may shape susceptibility to metabolic or respiratory diseases in the offspring but a programming effect on respiratory diseases induced by preeclampsia cannot be ruled out.
Objective The objective of the study was to examine the association between physical exercise during pregnancy and fetal growth measures. Study Design Data on 79,692 liveborn singletons from the ...Danish National Birth Cohort were collected between 1996 and 2002. Mean differences in birthweight, length, ponderal index, head and abdominal circumference, and placental weight and hazard ratios of small- and large-for-gestational-age babies were calculated. Results Our data indicated smaller babies in exercising women compared with nonexercisers, but the differences were small, and only a few were statistically significant. Exercising women had a slightly decreased risk of having a child small for gestational age (hazard ratio, 0.87; 95% confidence interval, 0.83–0.92) and large for gestational age (hazard ratio, 0.93; 95% confidence interval, 0.89–0.98). Conclusion The findings do not indicate sizable effects on fetal growth measures related to exercise apart from a modest decreased risk of small- and large-for-gestational-age infants. These findings do not speak against advising pregnant women to be physically active during pregnancy.
In patients without any history of atrial fibrillation (AF), detection of subclinical atrial high rate episodes (AHRE) by implanted devices has been associated with an increased thromboembolic risk. ...The predictive value of AHREs in patients with cardiac resynchronization therapy (CRT) is uncertain.
We aimed to investigate the prognostic value of early detected AHRE in patients with CRT.
This observational study included patients who received CRT and no history of AF. Patients had standard indication for CRT treatment. They were screened for early detected AHREs longer than 6 minutes occurring before 6-month follow-up, and the longest duration of AHREs was recorded. Information on clinical AF and thromboembolic events was obtained from the Danish National Patient Registry. The Cox regression model was used to compute hazard ratios (HRs) with 95% confidence intervals (CIs).
Of 394 eligible patients, 79 patients (20%) had early AHRE detected. During a median follow-up of 4.6 years, patients with early detected AHREs had an increased risk of clinical AF (HR 2.35; 95% CI 1.47-3.74; P < .001) and thromboembolic events (HR 2.30; 95% CI 1.09-4.83; P = .028). For patients with AHREs longer than 24 hours, these associations were stronger. The risk of mortality was not higher with early detected AHREs (HR 0.97; 95% CI 0.64-1.45; P = .87). Of the 27 patients with thromboembolic events, only 10 patients (37%) had AHREs detected within a 2-month period before the thromboembolic event.
In patients without any history of AF, detection of early AHREs after CRT implantation is associated with a significantly increased risk of clinical AF and thromboembolic events, particularly AHRE longer than 24 hours.
Working life, health and well-being of parents Ubalde-Lopez, Monica; Garani-Papadatos, Tina; Scelo, Ghislaine ...
Scandinavian journal of work, environment & health,
01/2021, Volume:
47, Issue:
7
Journal Article
Peer reviewed
Open access
Birth cohorts collect valuable and under-utilized information on employment and health of parents before and during pregnancy, at birth, and sometimes after birth. In this discussion paper, we ...examine how these data could be exploited to study the complex relationships and interactions between parenthood, work, and health among parents themselves.
Using a web-based database of birth cohorts, we summarize information on maternal employment and health conditions and other potentially related variables in cohorts spread throughout Europe. This provided information on what data are available and could be used in future studies, and what was missing if specific questions are to be addressed, exploiting the opportunity to explore work-health associations across heterogenous geographical and social contexts.
We highlight the many potentialities provided by birth cohorts and identify gaps that need to be addressed to adopt a life-course approach and investigate topics specific to the peri-pregnancy period, such as psychosocial aspects. We address the technical difficulties implied by data harmonization and the ethical challenges related to the repurposing of data, and provide scientific, ecological and economic arguments in favor of improving the value of data already available as a result of a serious investment in human and material resources.
There is a hidden treasure in birth cohorts that deserves to be brought out to study the relationships between employment and health among working parents in a time when the boundaries between work and life are being stretched more than ever before.
Lead complications are the main reason for reoperation after implantation of pacemakers (PM) or cardiac resynchronization therapy (CRT-P) devices.
This study sought to describe the incidence of lead ...complications causing reoperation after device implantation and to identify risk factors for lead complications.
A nationwide, population-based, historic cohort study was performed based on data from the Danish Pacemaker Register, which includes all Danish patients who received their first PM or CRT-P device from 1997 to 2008. Follow-up occurred 3 months after implantation.
The study population consisted of 28,860 patients. The incidence of any lead complication was 3.6%, encompassing right atrial (RA; 2.3%), right ventricular (2.2%), and left ventricular (4.3%) lead complications. The lead complication risk declined during the first part of the study period and remained stable after 2002. Multivariate analysis identified the following significant risk factors: chronic heart failure as indication (adjusted odds ratio (aOR) 3.0; 95% confidence interval CI 2.1 to 4.3), implantation in a nonuniversity center (aOR 1.4; 95% CI 1.2 to 1.6), inexperienced operator with <25 implantations (aOR 1.6; 95% CI 1.3 to 2.0), single-lead RA device (aOR 1.4; 95% CI 1.1 to 1.8), dual-chamber pacing device (aOR 1.6; 95% CI 1.4 to 1.9), CRT-P device (aOR 3.3; 95% CI 2.4 to 4.4) and passive-fixation RA lead (aOR 2.2; 95% CI 1.7 to 2.9).
Lead complications causing reoperation remain a clinically important problem in device therapy. Mainly procedure-related factors were identified as independent risk factors for lead complications.
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