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Association between congenital anomalies and area-level deprivation among infants in neonatal intensive care units.

https://arctichealth.org/en/permalink/ahliterature121777
Source
Am J Perinatol. 2013 Mar;30(3):225-32
Publication Type
Article
Date
Mar-2013
Author
Kate L Bassil
Sarah Collier
Lucia Mirea
Junmin Yang
Mary M K Seshia
Prakesh S Shah
Shoo K Lee
Author Affiliation
Maternal-Infant Care Research Centre (MiCare), Mount Sinai Hospital, Toronto, Canada. kbassil@mtsinai.on.ca
Source
Am J Perinatol. 2013 Mar;30(3):225-32
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Abnormalities, Multiple - epidemiology
Canada - epidemiology
Chromosome Aberrations - statistics & numerical data
Confidence Intervals
Health Status Disparities
Humans
Infant
Infant, Newborn
Intensive Care Units, Neonatal
Logistic Models
Odds Ratio
Poverty Areas
Prevalence
Risk assessment
Severity of Illness Index
Abstract
To examine the relationship between area-level material deprivation and the risk of congenital anomalies in infants admitted to neonatal intensive care units (NICUs) across Canada.
The Canadian Neonatal Network database was used to identify admitted infants who had congenital anomalies between 2005 and 2009. The association between congenital anomalies and material deprivation quintile was assessed using logistic regression analysis.
Of 55,961 infants admitted to participating NICUs during the study period, 6002 (10.7%) had major, 6244 (11.2%) had minor, and 43,715 (78.1%) had no anomalies. There were higher odds of major anomalies (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.03 to 1.24) but not minor anomalies (OR 1.01, 95% CI 0.93 to 1.11) in the highest-deprivation areas as compared with the lowest-deprivation area of maternal residence. Analyses of groups of major anomalies revealed higher odds for chromosomal (OR 1.48, 95% CI 1.05 to 2.10) and multiple-systems (OR 1.40, 95% CI 1.14 to 1.71) anomalies in the highest-deprivation areas compared with the lowest-deprivation areas.
There are socioeconomic inequalities in the risk of major congenital anomalies, especially chromosomal and multiple-systems anomalies, in the NICU population with the highest rates in the most socioeconomically deprived areas.
PubMed ID
22879358 View in PubMed
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Outcomes of neonatal patent ductus arteriosus ligation in Canadian neonatal units with and without pediatric cardiac surgery programs.

https://arctichealth.org/en/permalink/ahliterature113672
Source
J Pediatr Surg. 2013 May;48(5):909-14
Publication Type
Article
Date
May-2013
Author
Charles Wong
Michael Mak
Sandesh Shivananda
Junmin Yang
Prakeshkumar S Shah
Wendy Seidlitz
Julia Pemberton
Peter G Fitzgerald
Brian H Cameron
Author Affiliation
McMaster Pediatric Surgery Research Collaborative, Hamilton ON, Canada.
Source
J Pediatr Surg. 2013 May;48(5):909-14
Date
May-2013
Language
English
Publication Type
Article
Keywords
Abnormalities, Multiple - epidemiology
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Brain Diseases - epidemiology - etiology - ultrasonography
Canada
Cardiology Service, Hospital - organization & administration
Combined Modality Therapy
Databases, Factual
Ductus Arteriosus, Patent - drug therapy - mortality - surgery
Female
Hospital Departments - organization & administration
Hospital Mortality
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases - mortality - surgery
Infant, Small for Gestational Age
Intensive Care Units, Neonatal - statistics & numerical data
Ligation
Male
Patient Transfer - statistics & numerical data
Pediatrics - organization & administration
Postoperative Complications - epidemiology - etiology - ultrasonography
Retrospective Studies
Sepsis - epidemiology - etiology
Severity of Illness Index
Surgery Department, Hospital - organization & administration
Tertiary Care Centers - organization & administration - statistics & numerical data
Treatment Outcome
Abstract
Preterm infants needing patent ductus arteriosus (PDA) ligation are transferred to a pediatric cardiac center (CC) unless the operation can be done locally by a pediatric surgeon at a non-cardiac center (NCC). We compared infant outcomes after PDA ligation at CC and NCC.
We analyzed 990 preterm infants who had PDA ligation between 2005 and 2009 using the Canadian Neonatal Network database. In-hospital mortality and major morbidities were compared between CC (n=18) and NCC (n=9).
SNAP-II-adjusted mortality rates were similar (CC=8.7% vs NCC=10.7%, P=.32). Significant cranial ultrasound abnormalities (CC=24.1% vs NCC=32.1%, P
PubMed ID
23701758 View in PubMed
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Prediction of neonatal outcomes in extremely preterm neonates.

https://arctichealth.org/en/permalink/ahliterature107072
Source
Pediatrics. 2013 Oct;132(4):e876-85
Publication Type
Article
Date
Oct-2013
Author
Wen J Ge
Lucia Mirea
Junmin Yang
Kate L Bassil
Shoo K Lee
Prakeshkumar S Shah
Author Affiliation
Maternal-Infant Care (MiCare) Research Centre, Mount Sinai Hospital, 700 University Ave, Suite 8-500, Toronto, Ontario M5G 1X6. lmirea@mtsinai.on.ca.
Source
Pediatrics. 2013 Oct;132(4):e876-85
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Cohort Studies
Databases, Factual - trends
Humans
Infant, Extremely Premature - physiology
Infant, Newborn
Infant, Premature, Diseases - diagnosis - mortality - therapy
Intensive Care Units, Neonatal - trends
Population Surveillance - methods
Predictive value of tests
Risk factors
Survival Rate - trends
Treatment Outcome
Abstract
To develop and validate a statistical prediction model spanning the severity range of neonatal outcomes in infants born at = 30 weeks' gestation.
A national cohort of infants, born at 23 to 30 weeks' gestation and admitted to level III NICUs in Canada in 2010-2011, was identified from the Canadian Neonatal Network database. A multinomial logistic regression model was developed to predict survival without morbidities, mild morbidities, severe morbidities, or mortality, using maternal, obstetric, and infant characteristics available within the first day of NICU admission. Discrimination and calibration were assessed using a concordance C-statistic and the Cg goodness-of-fit test, respectively. Internal validation was performed using a bootstrap approach.
Of 6106 eligible infants, 2280 (37%) survived without morbidities, 1964 (32%) and 1251 (21%) survived with mild and severe morbidities, respectively, and 611 (10%) died. Predictors in the model were gestational age, small (20, outborn status, use of antenatal corticosteroids, and receipt of surfactant and mechanical ventilation on the first day of admission. High model discrimination was confirmed by internal bootstrap validation (bias-corrected C-statistic = 0.899, 95% confidence interval = 0.894-0.903). Predicted probabilities were consistent with the observed outcomes (Cg P value = .96).
Neonatal outcomes ranging from mortality to survival without morbidity in extremely preterm infants can be predicted on their first day in the NICU by using a multinomial model with good discrimination and calibration. The prediction model requires additional external validation.
PubMed ID
24062365 View in PubMed
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Spatial variability of gastroschisis in Canada, 2006-2011: An exploratory analysis.

https://arctichealth.org/en/permalink/ahliterature273824
Source
Can J Public Health. 2016;107(1):e62-7
Publication Type
Article
Date
2016
Author
Kate L Bassil
Junmin Yang
Laura Arbour
Rahim Moineddin
Mary E Brindle
Emily Hazell
Erik D Skarsgard
Source
Can J Public Health. 2016;107(1):e62-7
Date
2016
Language
English
Publication Type
Article
Abstract
Gastroschisis is a serious birth defect of the abdominal wall that is associated with mortality and significant morbidity. Our understanding of the factors causing this defect is limited. The objective of this paper is to describe the geographic variation in incidence of gastroschisis and characterize the spatial pattern of all gastroschisis cases in Canada between 2006 and 2011. Specifically, we aimed to ascertain the differences in spatial patterns between geographic regions and identify significant clusters and their location.
The study population included 641 gastroschisis cases from the Canadian Pediatric Surgery Network (CAPSNet) database, a population-based dataset of all gastroschisis cases in Canada. Cases were geocoded based on maternal residence. Using Statistics Canada live-birth data as a denominator, the total prevalence of gastroschisis was calculated at the provincial/territorial levels. Random effects logistic models were used to estimate the rates of gastroschisis in each census division. These rates were then mapped using ArcGIS. Cluster detection was performed using Local Indicators of Spatial Association (LISA).
There is significant spatial heterogeneity of the rate of gastroschisis across Canada at both the provincial/territorial and census-division level. The Yukon, Northwest Territories and Prince Edward Island have higher overall rates of gastroschisis relative to other provinces/territories. Several census divisions in Alberta, Manitoba, Saskatchewan, Ontario, Northwest Territories and British Columbia demonstrated case "clusters", i.e., focally higher rates in discrete areas relative to surrounding areas.
There is clear evidence of spatial variation in the rates of gastroschisis across Canada. Future research should explore the role of area-based variables in these patterns to improve our understanding of the etiology of gastroschisis.
PubMed ID
27348112 View in PubMed
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