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Acquisition and elimination of bacterial vaginosis during pregnancy: a Danish population-based study.

https://arctichealth.org/en/permalink/ahliterature163704
Source
Infect Dis Obstet Gynecol. 2006;2006:94646
Publication Type
Article
Date
2006
Author
Ida Vogel
Poul Thorsen
Bernard Jeune
Bo Jacobsson
Niels Ebbesen
Magnus Arpi
Annie Bremmelgaard
Birger R Møller
Source
Infect Dis Obstet Gynecol. 2006;2006:94646
Date
2006
Language
English
Publication Type
Article
Keywords
Bacteria, Anaerobic - growth & development
Cohort Studies
Denmark - epidemiology
Female
Humans
Hydrogen-Ion Concentration
Incidence
Lactobacillus - growth & development
Pregnancy
Pregnancy Complications, Infectious - diagnosis - epidemiology - microbiology - prevention & control
Pregnancy Trimester, Second
Pregnancy Trimester, Third
Prevalence
Risk factors
Smoking - adverse effects
Vaginosis, Bacterial - diagnosis - epidemiology - microbiology - prevention & control
Abstract
the aim was to examine factors associated with acquisition and elimination of bacterial vaginosis in pregnancy.
a group of 229 pregnant women were randomly selected from a population-based prospective cohort study of 2927. They were examined at enrollment (mean gestational weeks 16w+0d) and again in mid-third trimester (mean gestational age 32w+3d).
BV (Amsel's clinical criteria), microbiological cultures of the genital tract and questionnaire data.
BV prevalence decreased from 17% in early second trimester to 14% in mid-third trimester due to a tenfold higher elimination rate (39%) than incidence rate (4%). Heavy smokers (>10/d) in early pregnancy were at increased risk (5.3[1.1-25]) for the acquisition of BV during pregnancy, as were women receiving public benefits (4.8[1.0-22]), having a vaginal pH above 4.5(6.3[1.4-29]) or vaginal anaerobe bacteria (18[2.7-122]) at enrollment. A previous use of combined oral contraceptives was preventive for the acquisition of BV (0.2[0.03-0.96]). Elimination of BV in pregnancy tended to be associated with a heavy growth of Lactobacillus(3.2[0.8-13]) at enrollment.
acquisition of BV during pregnancy is rare and is associated with smoking, while the presence of anaerobe bacteria and a vaginal pH >4.5 are interpreted as steps on a gradual change towards BV. In the same way heavy growth of Lactobacillus spp in early pregnancy may be an indicator of women on the way to eliminate BV.
Notes
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PubMed ID
17485815 View in PubMed
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Advanced maternal age and adverse perinatal outcome.

https://arctichealth.org/en/permalink/ahliterature47166
Source
Obstet Gynecol. 2004 Oct;104(4):727-33
Publication Type
Article
Date
Oct-2004
Author
Bo Jacobsson
Lars Ladfors
Ian Milsom
Author Affiliation
Perinatal Centre, Department of Obstetrics and Gynecology, Sahlgrenska University Hospital/Ostra, S-416 85 Göteborg, Sweden. bo.jacobsson@obgyn.gu.se
Source
Obstet Gynecol. 2004 Oct;104(4):727-33
Date
Oct-2004
Language
English
Publication Type
Article
Keywords
Adult
Female
Humans
Infant mortality
Infant, Newborn
Infant, Newborn, Diseases - mortality
Maternal Age
Middle Aged
Obstetric Labor Complications - epidemiology - etiology
Pregnancy
Pregnancy outcome
Pregnancy, High-Risk
Registries
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Abstract
OBJECTIVE: The aim of this study was to investigate the influence of maternal age on perinatal and obstetric outcome in women aged 40-44 years and those 45 years or older and to estimate whether adverse outcome was related to intercurrent illness and pregnancy complications. METHODS: National prospective, population-based, cohort study in women aged 40-44 years and those 45 years or older and in a control group of women aged 20-29 years who delivered during the period 1987-2001. Adjusted odds ratios (OR) were calculated after adjustments for significant malformations, maternal pre-existing diseases, and smoking. Main outcome measures were perinatal mortality, intrauterine fetal death, neonatal death, preterm birth, and preeclampsia. RESULTS: During the 15-year period, there were 1,566,313 deliveries (876,361 women were 20-29 years of age, 31,662 were 40-44 years, and 1,205 were > or = 45 years). Perinatal mortality was 1.4%, 1.0%, and 0.5% in women 45 years or older, 40-44, and 20-29 years, respectively. Adjusted OR for perinatal mortality was 2.4 (95% confidence interval [CI] 1.5-4.0) in women aged 45 years or older, compared with 1.7 (95% CI 1.5-1.9) in women 40-44 years. Adjusted OR for intrauterine fetal death was 3.8 (95% CI 2.2-6.4) in women aged 45 years or older, compared with 2.1 (95% CI 1.8-2.4) in women 40-44 years. Preterm birth, gestational diabetes, and preeclampsia were more common among women 40-44 years of age and those 45 years or older. Perinatal mortality was increased in women with intercurrent illness or pregnancy complications compared with women without these conditions, but there was no evidence that these factors became more important with increasing age. CONCLUSION: Perinatal mortality, intrauterine fetal death, and neonatal death increased with age. There was also an increase in intercurrent illnesses and pregnancy complications with increasing age, but this did not entirely explain the observed increase in perinatal mortality with age. LEVEL OF EVIDENCE: II-3
PubMed ID
15458893 View in PubMed
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Antecedents and neuroimaging patterns in cerebral palsy with epilepsy and cognitive impairment: a population-based study in children born at term.

https://arctichealth.org/en/permalink/ahliterature284884
Source
Acta Obstet Gynecol Scand. 2017 Jul;96(7):828-836
Publication Type
Article
Date
Jul-2017
Author
Kristina Ahlin
Bo Jacobsson
Staffan Nilsson
Kate Himmelmann
Source
Acta Obstet Gynecol Scand. 2017 Jul;96(7):828-836
Date
Jul-2017
Language
English
Publication Type
Article
Keywords
Cerebral Palsy - complications - diagnostic imaging
Child, Preschool
Cognition Disorders - complications - diagnostic imaging
Cohort Studies
Epilepsy - complications - diagnostic imaging
Female
Humans
Infant, Newborn
Magnetic Resonance Imaging
Male
Obstetric Labor Complications - epidemiology
Pregnancy
Pregnancy Complications - epidemiology
Registries
Sweden - epidemiology
Term Birth
Abstract
Antecedents of accompanying impairments in cerebral palsy and their relation to neuroimaging patterns need to be explored.
A population-based study of 309 children with cerebral palsy born at term between 1983 and 1994. Prepartum, intrapartum, and postpartum variables previously studied as antecedents of cerebral palsy type and motor severity were analyzed in children with cerebral palsy and cognitive impairment and/or epilepsy, and in children with cerebral palsy without these accompanying impairments. Neuroimaging patterns and their relation to identified antecedents were analyzed. Data were retrieved from the cerebral palsy register of western Sweden, and from obstetric and neonatal records.
Children with cerebral palsy and accompanying impairments more often had low birthweight (kg) (odds ratio 0.5, 95% confidence interval 0.3-0.8), brain maldevelopment known at birth (p = 0.007, odds ratio 8) and neonatal infection (odds ratio 5.4, 95% confidence interval 1.04-28.4). Moreover, neuroimaging patterns of maldevelopment (odds ratio 7.2, 95% confidence interval 2.9-17.2), cortical/subcortical lesions (odds ratio 5.3, 95% confidence interval 2.3-12.2) and basal ganglia lesions (odds ratio 7.6, 95% confidence interval 1.4-41.3) were more common, wheras white matter injury was found significantly less often (odds ratio 0.2, 95% confidence interval 0.1-0.5). In most children with maldevelopment, the intrapartum and postpartum periods were uneventful (p
PubMed ID
28295155 View in PubMed
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Assessing the Causal Relationship of Maternal Height on Birth Size and Gestational Age at Birth: A Mendelian Randomization Analysis.

https://arctichealth.org/en/permalink/ahliterature271296
Source
PLoS Med. 2015 Aug;12(8):e1001865
Publication Type
Article
Date
Aug-2015
Author
Ge Zhang
Jonas Bacelis
Candice Lengyel
Kari Teramo
Mikko Hallman
Øyvind Helgeland
Stefan Johansson
Ronny Myhre
Verena Sengpiel
Pål Rasmus Njølstad
Bo Jacobsson
Louis Muglia
Source
PLoS Med. 2015 Aug;12(8):e1001865
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Body Height
Body Weight
Causality
Denmark
Female
Finland
Gestational Age
Haplotypes
Humans
Infant, Newborn
Mendelian Randomization Analysis
Mothers
Norway
Phenotype
Polymorphism, Single Nucleotide
Pregnancy
Abstract
Observational epidemiological studies indicate that maternal height is associated with gestational age at birth and fetal growth measures (i.e., shorter mothers deliver infants at earlier gestational ages with lower birth weight and birth length). Different mechanisms have been postulated to explain these associations. This study aimed to investigate the casual relationships behind the strong association of maternal height with fetal growth measures (i.e., birth length and birth weight) and gestational age by a Mendelian randomization approach.
We conducted a Mendelian randomization analysis using phenotype and genome-wide single nucleotide polymorphism (SNP) data of 3,485 mother/infant pairs from birth cohorts collected from three Nordic countries (Finland, Denmark, and Norway). We constructed a genetic score based on 697 SNPs known to be associated with adult height to index maternal height. To avoid confounding due to genetic sharing between mother and infant, we inferred parental transmission of the height-associated SNPs and utilized the haplotype genetic score derived from nontransmitted alleles as a valid genetic instrument for maternal height. In observational analysis, maternal height was significantly associated with birth length (p = 6.31 ? 10-9), birth weight (p = 2.19 ? 10-15), and gestational age (p = 1.51 ? 10-7). Our parental-specific haplotype score association analysis revealed that birth length and birth weight were significantly associated with the maternal transmitted haplotype score as well as the paternal transmitted haplotype score. Their association with the maternal nontransmitted haplotype score was far less significant, indicating a major fetal genetic influence on these fetal growth measures. In contrast, gestational age was significantly associated with the nontransmitted haplotype score (p = 0.0424) and demonstrated a significant (p = 0.0234) causal effect of every 1 cm increase in maternal height resulting in ~0.4 more gestational d. Limitations of this study include potential influences in causal inference by biological pleiotropy, assortative mating, and the nonrandom sampling of study subjects.
Our results demonstrate that the observed association between maternal height and fetal growth measures (i.e., birth length and birth weight) is mainly defined by fetal genetics. In contrast, the association between maternal height and gestational age is more likely to be causal. In addition, our approach that utilizes the genetic score derived from the nontransmitted maternal haplotype as a genetic instrument is a novel extension to the Mendelian randomization methodology in casual inference between parental phenotype (or exposure) and outcomes in offspring.
Notes
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PubMed ID
26284790 View in PubMed
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Association between intake of artificially sweetened and sugar-sweetened beverages and preterm delivery: a large prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature122026
Source
Am J Clin Nutr. 2012 Sep;96(3):552-9
Publication Type
Article
Date
Sep-2012
Author
Linda Englund-Ögge
Anne Lise Brantsæter
Margareta Haugen
Verena Sengpiel
Ali Khatibi
Ronny Myhre
Solveig Myking
Helle Margrete Meltzer
Marian Kacerovsky
Roy M Nilsen
Bo Jacobsson
Author Affiliation
Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden. linda.englund-ogge@vgregion.se
Source
Am J Clin Nutr. 2012 Sep;96(3):552-9
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Beverages - adverse effects
Carbonated Beverages - adverse effects
Cohort Studies
Dietary Sucrose - adverse effects
Educational Status
Energy intake
Female
Follow-Up Studies
Humans
Norway
Obstetric Labor, Premature - etiology
Overweight - complications
Pregnancy
Prospective Studies
Questionnaires
Registries
Single Person
Smoking - adverse effects
Sweetening Agents - adverse effects
Thinness - complications
Abstract
Artificially sweetened (AS) and sugar-sweetened (SS) beverages are commonly consumed during pregnancy. A recent Danish study reported that the daily intake of an AS beverage was associated with an increased risk of preterm delivery.
We examined the intake of AS and SS beverages in pregnant women to replicate the Danish study and observe whether AS intake is indeed associated with preterm delivery.
This was a prospective study of 60,761 pregnant women in the Norwegian Mother and Child Cohort Study. Intakes of carbonated and noncarbonated AS and SS beverages and use of artificial sweeteners in hot drinks were assessed by a self-reported food-frequency questionnaire in midpregnancy. Preterm delivery was the primary outcome, and data were obtained from the Norwegian Medical Birth Registry.
Intakes of both AS and SS beverages increased with increasing BMI and energy intake and were higher in women with less education, in daily smokers, and in single women. A high intake of AS beverages was associated with preterm delivery; the adjusted OR for those drinking >1 serving/d was 1.11 (95% CI: 1.00, 1.24). Drinking >1 serving of SS beverages per day was also associated with an increased risk of preterm delivery (adjusted OR: 1.25; 95% CI: 1.08, 1.45). The trend tests were positive for both beverage types.
This study suggests that a high intake of both AS and SS beverages is associated with an increased risk of preterm delivery.
Notes
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PubMed ID
22854404 View in PubMed
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Bacterial vaginosis in early pregnancy may predispose for preterm birth and postpartum endometritis.

https://arctichealth.org/en/permalink/ahliterature63597
Source
Acta Obstet Gynecol Scand. 2002 Nov;81(11):1006-10
Publication Type
Article
Date
Nov-2002
Author
Bo Jacobsson
Peter Pernevi
Lene Chidekel
Jens Jörgen Platz-Christensen
Author Affiliation
Perinatal Center, Department of Obstetrics and Gynecology, Institute of Health for Women and Children, Sahlgrenska University Hospital, Maternity Health Care Unit, Göteborg, Sweden. bo.jacobsson@obgyn.gu.se
Source
Acta Obstet Gynecol Scand. 2002 Nov;81(11):1006-10
Date
Nov-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cohort Studies
Endometritis - etiology
Female
Humans
Logistic Models
Obstetric Labor, Premature - etiology
Postpartum Period
Pregnancy
Pregnancy Complications, Infectious - epidemiology - microbiology
Pregnancy Trimester, First
Prevalence
Prospective Studies
Risk factors
Sweden - epidemiology
Vaginal Smears
Vaginosis, Bacterial - complications - epidemiology - microbiology
Abstract
BACKGROUND: Bacterial vaginosis (BV) has been reported to be associated with spontaneous preterm delivery and infectious morbidity after birth in non-Swedish populations. Our intention was to investigate the situation in a Swedish population. METHODS: In this cohort study, 924 patients were enrolled consecutively. A Papanicolaou (Pap) smear, which included a posterior fornix sample, was obtained at the first visit (median: 12 weeks and 1 day) at the two antenatal care units in central Göteborg 1990-91. Clue cells in the Pap smear were considered to be consistent with BV. The principal outcome variables were spontaneous preterm birth (
PubMed ID
12421167 View in PubMed
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Caffeine exposure during pregnancy, small for gestational age birth and neonatal outcome - results from the Norwegian Mother and Child Cohort Study.

https://arctichealth.org/en/permalink/ahliterature301107
Source
BMC Pregnancy Childbirth. 2019 Feb 26; 19(1):80
Publication Type
Journal Article
Date
Feb-26-2019
Author
Dominika Modzelewska
Rino Bellocco
Anders Elfvin
Anne Lise Brantsæter
Helle Margrete Meltzer
Bo Jacobsson
Verena Sengpiel
Author Affiliation
Institute of Clinical Sciences, Department of Obstetrics and Gynecology, University of Gothenburg, Sahlgrenska Academy, SE-416 85, Gothenburg, Sweden. dominika.modzelewska@gu.se.
Source
BMC Pregnancy Childbirth. 2019 Feb 26; 19(1):80
Date
Feb-26-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Birth Weight - drug effects
Caffeine - adverse effects
Cohort Studies
Female
Gestational Age
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Newborn, Diseases - chemically induced
Infant, Small for Gestational Age
Logistic Models
Maternal Exposure - adverse effects
Norway
Pregnancy
Premature Birth - chemically induced
Registries
Risk factors
Abstract
Maternal caffeine intake has repeatedly been linked to babies being born small for gestational age (SGA). SGA babies are known to be at increased risk for adverse neonatal outcomes. The aim of this study was to explore the associations between prenatal caffeine exposure and neonatal health.
The study is based on 67,569 full-term singleton mother-infant pairs from the Norwegian Mother and Child Cohort Study. Caffeine consumption from different sources was self-reported in gestational week 22. Neonatal compound outcomes, namely (1) morbidity/mortality and (2) neonatal intervention, were created based on the Medical Birth Registry of Norway. Adjusted logistic regression was performed.
Caffeine exposure was associated to SGA (OR?=?1.16, 95%CI: 1.10; 1.23) and being born SGA was significantly associated with neonatal health (OR?=?3.09, 95%CI: 2.54; 3.78 for morbidity/mortality; OR?=?3.94, 95%CI: 3.50; 4.45 for intervention). However, prenatal caffeine exposure was neither associated with neonatal morbidity/mortality (OR?=?1.01, 95%CI: 0.96; 1.07) nor neonatal intervention (OR?=?1.02, 95%CI: 1.00; 1.05 for a 100?mg caffeine intake increase). Results did not change after additional adjustment for SGA status.
Moderate prenatal caffeine exposure (
PubMed ID
30808339 View in PubMed
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Candidate gene analysis of spontaneous preterm delivery: new insights from re-analysis of a case-control study using case-parent triads and control-mother dyads.

https://arctichealth.org/en/permalink/ahliterature128324
Source
BMC Med Genet. 2011;12:174
Publication Type
Article
Date
2011
Author
Solveig Myking
Ronny Myhre
Håkon K Gjessing
Nils-Halvdan Morken
Verena Sengpiel
Scott M Williams
Kelli K Ryckman
Per Magnus
Bo Jacobsson
Author Affiliation
Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway. solveig.myking@fhi.no
Source
BMC Med Genet. 2011;12:174
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Case-Control Studies
Cohort Studies
Collagen Type V - genetics
Data Interpretation, Statistical
Female
Genetic Association Studies
Genetic Predisposition to Disease
Humans
Infant, Newborn
Infant, Premature
Male
Middle Aged
Norway
Polymorphism, Single Nucleotide
Pregnancy
Premature Birth - genetics
Young Adult
Abstract
Spontaneous preterm delivery (PTD) has a multifactorial etiology with evidence of a genetic contribution to its pathogenesis. A number of candidate gene case-control studies have been performed on spontaneous PTD, but the results have been inconsistent, and do not fully assess the role of how two genotypes can impact outcome. To elucidate this latter point we re-analyzed data from a previously published case-control candidate gene study, using a case-parent triad design and a hybrid design combining case-parent triads and control-mother dyads. These methods offer a robust approach to genetic association studies for PTD compared to traditional case-control designs.
The study participants were obtained from the Norwegian Mother and Child Cohort Study (MoBa). A total of 196 case triads and 211 control dyads were selected for the analysis. A case-parent triad design as well as a hybrid design was used to analyze 1,326 SNPs from 159 candidate genes. We compared our results to those from a previous case-control study on the same samples. Haplotypes were analyzed using a sliding window of three SNPs and a pathway analysis was performed to gain biological insight into the pathophysiology of preterm delivery.
The most consistent significant fetal gene across all analyses was COL5A2. The functionally similar COL5A1 was significant when combining fetal and maternal genotypes. PON1 was significant with analytical approaches for single locus association of fetal genes alone, but was possibly confounded by maternal effects. Focal adhesion (hsa04510), Cell Communication (hsa01430) and ECM receptor interaction (hsa04512) were the most constant significant pathways.
This study suggests a fetal association of COL5A2 and a combined fetal-maternal association of COL5A1 with spontaneous PTD. In addition, the pathway analysis implied interactions of genes affecting cell communication and extracellular matrix.
Notes
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PubMed ID
22208904 View in PubMed
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Cerebral palsy and perinatal infection in children born at term.

https://arctichealth.org/en/permalink/ahliterature113293
Source
Obstet Gynecol. 2013 Jul;122(1):41-9
Publication Type
Article
Date
Jul-2013
Author
Kristina Ahlin
Kate Himmelmann
Gudrun Hagberg
Marian Kacerovsky
Teresa Cobo
Ulla-Britt Wennerholm
Bo Jacobsson
Author Affiliation
Perinatal Center, Department of Obstetrics and Gynaecology, Institute for Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital/Östra, Sweden.
Source
Obstet Gynecol. 2013 Jul;122(1):41-9
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Case-Control Studies
Cerebral Palsy - epidemiology - microbiology
Female
Fetal Diseases - epidemiology - microbiology
Humans
Infant, Newborn
Infection - complications - epidemiology - microbiology
Pregnancy
Risk assessment
Risk factors
Sweden - epidemiology
Abstract
To investigate the link between infection-related risk factors for cerebral palsy subtypes in children born at term.
A case-control study was performed in a population-based series of children with cerebral palsy born at term (n=309) matched with a control group (n=618). The cases were divided into cerebral palsy subtypes: spastic hemiplegia, spastic diplegia, spastic tetraplegia, and dyskinetic cerebral palsy. All forms of spastic cerebral palsy were also analyzed together. All records were examined for maternal and neonatal signs of infection. Univariate and adjusted analyses were performed.
Infection-related risk factors were shown to be independent risk factors for spastic cerebral palsy in the adjusted analyses. This was especially pronounced in the subgroup with spastic hemiplegia in which bacterial growth in urine during pregnancy (n=11 [7.5%], odds ratio [OR] 4.7, 95% confidence interval [CI] 1.5-15.2), any infectious disease during pregnancy (n=57 [39.0%], OR 2.9, 95% CI 1.7-4.8), severe infection during pregnancy (n=12 [8.2%], OR 15.4, 95% CI 3.0-78.1), antibiotic therapy once during pregnancy (n=33 [22.6%], OR 6.3, 95% CI 3.0-15.2) as well as several times during pregnancy (n=9 [6.2%], OR 15.6, 95% CI 1.8-134.2) constituted strong independent risk factors. However, only neonatal infection (n=11 [9.1%], OR 14.7, 95% CI 1.7-126.5) was independently significantly associated with an increased risk of spastic diplegia and tetraplegia.
Infection-related factors are strong independent risk factors for the subgroup with spastic hemiplegia in children with cerebral palsy born at term. The finding is less pronounced in the subgroups with spastic diplegia or tetraplegia.
II.
PubMed ID
23743468 View in PubMed
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Cerebral palsy, autism spectrum disorders, and developmental delay in children born after assisted conception: a systematic review and meta-analysis.

https://arctichealth.org/en/permalink/ahliterature153331
Source
Arch Pediatr Adolesc Med. 2009 Jan;163(1):72-83
Publication Type
Article
Date
Jan-2009
Author
Dorte Hvidtjørn
Laura Schieve
Diana Schendel
Bo Jacobsson
Claus Svaerke
Poul Thorsen
Author Affiliation
NANEA, Institute of Public Health, Department of Epidemiology, University of Aarhus, Paludan-Müllers vej 17, 8000 Aarhus C, Denmark. dh@soci.au.dk
Source
Arch Pediatr Adolesc Med. 2009 Jan;163(1):72-83
Date
Jan-2009
Language
English
Publication Type
Article
Keywords
Adult
Autistic Disorder - epidemiology - etiology
Cerebral Palsy - epidemiology - etiology
Child
Child, Preschool
Denmark - epidemiology
Developmental Disabilities - epidemiology - etiology
Female
Fertilization in Vitro - adverse effects
Humans
Infant
Infant, Newborn
Male
Pregnancy
Premature Birth - epidemiology - etiology
Prevalence
Prognosis
Reproductive Techniques, Assisted - adverse effects
Risk assessment
Sperm Injections, Intracytoplasmic - adverse effects
Abstract
To assess the existing evidence of associations between assisted conception and cerebral palsy (CP), autism spectrum disorders (ASD), and developmental delay.
Forty-one studies identified in a systematical PubMed and Excerpta Medica Database (EMBASE) search for articles published from January 1, 1996, to April 1, 2008.
Studies written in English comparing children born after assisted conception with children born after natural conception assessing CP, ASD, and developmental delay, based on original data with a follow-up of 1 year or more. Main Exposures In vitro fertilization (IVF) with or without intracytoplasmic sperm injection or ovulation induction with or without subsequent intrauterine insemination.
Cerebral palsy, ASD, and developmental delay.
Nine CP studies showed that children born after IVF had an increased risk of CP associated with preterm delivery. In our meta-analysis including 19 462 children exposed to IVF, we estimated a crude odds ratio of 2.18 (95% confidence interval, 1.71-2.77). Eight ASD studies and 30 studies on developmental delay showed inconsistent results. No studies assessed the risk of CP, ASD, or developmental delay in children born after ovulation induction exclusively.
Methodological problems were revealed in the identified studies, and the gaps in our knowledge about the long-term outcomes of children born after assisted conception are considerable, including a lack of information on the long-term consequences of ovulation induction. Possible associations with ASD and developmental delay need assessment in larger studies. Studies on assisted conception and CP from countries outside of Scandinavia are needed, including detailed information on time to pregnancy, underlying cause of infertility, and type of IVF treatment.
PubMed ID
19124707 View in PubMed
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