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Acculturation and celiac disease risk in second-generation immigrants: a nationwide cohort study in Sweden.

https://arctichealth.org/en/permalink/ahliterature122335
Source
Scand J Gastroenterol. 2012 Oct;47(10):1174-80
Publication Type
Article
Date
Oct-2012
Author
Carl Johan Wingren
Daniel Agardh
Juan Merlo
Author Affiliation
Unit for Social Epidemiology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Malmö, Sweden. carl_johan.wingren@med.lu.se
Source
Scand J Gastroenterol. 2012 Oct;47(10):1174-80
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Acculturation
Celiac Disease - epidemiology
Child
Child, Preschool
Cohort Effect
Cohort Studies
Cost of Illness
Emigrants and Immigrants - statistics & numerical data
Environmental health
Female
Health Status Disparities
Humans
Incidence
Male
Mothers - statistics & numerical data
Proportional Hazards Models
Registries - statistics & numerical data
Risk assessment
Risk factors
Sweden - epidemiology
Time Factors
Young Adult
Abstract
The burden of celiac disease (CD) is increasingly recognized as a global problem. However, whether this situation depends on genetics or environmental factors is uncertain. The authors examined these aspects in Sweden, a country in which the risk of CD is generally considered to be high. If environmental factors are relevant, CD risk in second-generation immigrant children should be related to maternal length of stay in Sweden before delivery.
Linking the Swedish Medical Birth Registry to other national registries, the authors investigated all singleton children (n = 792,401) born in Sweden between 1987 and 1993. They studied the risk of CD in children before age 6 as a function of the mother's geographical region of birth and length of stay in Sweden before delivery using Cox regression models.
In children whose mothers immigrated to Sweden from a country outside of Europe, a maternal length of stay in Sweden of more than 5 years increased the hazard ratio (HR) of CD (1.73, 95% confidence interval (CI) 1.06-2.81). The authors observed a similar result among children born to mothers from a Nordic country outside of Sweden (HR 1.57, 95% CI 0.89-2.75), but a non-conclusive protective effect was observed in second-generation immigrant children from a non-Nordic European country (HR 0.65, 95% CI 0.39-1.09).
The risk of CD among second-generation immigrants seems to be conditioned by maternal length of stay in Sweden before delivery, suggesting that environmental factors contribute to the variation in CD risk observed across populations.
PubMed ID
22827636 View in PubMed
Less detail

Adult children's socioeconomic resources and mothers' survival after a breast cancer diagnosis: a Swedish population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature287819
Source
BMJ Open. 2017 Mar 30;7(3):e014968
Publication Type
Article
Date
Mar-30-2017
Author
Hannah L Brooke
Gunilla Ringbäck Weitoft
Mats Talbäck
Maria Feychting
Rickard Ljung
Source
BMJ Open. 2017 Mar 30;7(3):e014968
Date
Mar-30-2017
Language
English
Publication Type
Article
Keywords
Adult
Adult Children - statistics & numerical data
Aged
Breast Neoplasms - mortality
Cancer Survivors - statistics & numerical data
Educational Status
Female
Health Status Disparities
Humans
Income
Middle Aged
Mothers - statistics & numerical data
Socioeconomic Factors
Sweden - epidemiology
Abstract
Socioeconomic inequalities in survival after breast cancer persist worldwide. We aim to determine whether adult offspring's socioeconomic resources contribute to inequalities in mothers' survival after breast cancer.
14 231 women, aged 65-79 years, with a child aged =30 years and a first primary diagnosis of breast cancer in the National Cancer Register between 2001 and 2010 were followed until death, 10 years after diagnosis, or end of study (December 2015). Relative survival proportions and excess mortality within 10 years of diagnosis by strata of offspring's education level and disposable income were estimated using flexible parametric models accounting for measures of mothers' socioeconomic position and expected mortality in the general population.
4292 women died during 102 236 person-years of follow-up. Crude 10-year relative survival proportions for mothers of children with >14, 12-14 and 14 years of education, mothers of children with
Notes
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PubMed ID
28363931 View in PubMed
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Appropriate assessment of ethnic differences in adolescent use of psychotropic medication: multilevel analysis of discriminatory accuracy.

https://arctichealth.org/en/permalink/ahliterature289566
Source
Ethn Health. 2016 12; 21(6):578-95
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
12-2016
Author
Anna-Karin Ivert
Shai Mulinari
Willemijn van Leeuwen
Philippe Wagner
Juan Merlo
Author Affiliation
a Faculty of Medicine, Unit for Social Epidemiology , CRC, Skåne University Hospital, Lund University , Malmö , Sweden.
Source
Ethn Health. 2016 12; 21(6):578-95
Date
12-2016
Language
English
Geographic Location
Sweden
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Developing Countries
Drug Utilization - statistics & numerical data
Female
Humans
Male
Mothers - statistics & numerical data
Multilevel Analysis
Psychotropic Drugs - economics - therapeutic use
ROC Curve
Registries
Risk factors
Socioeconomic Factors
Sweden - epidemiology
Young Adult
Abstract
In the present study, we used a multilevel approach to investigate the role of maternal country of birth (MCOB) in predicting adolescent use of psychotropic medication in Sweden.
Using the Swedish Medical Birth Register we identified all 428,314 adolescents born between 1987 and 1990 and who were residing in Sweden in the year they turned 18. We applied multilevel logistic regression analysis with adolescents (level 1) nested within MCOBs (level 2). Measures of association (odds ratio) and measures of variance (intra-class correlation (ICC)) were calculated, as well as the discriminatory accuracy by calculating the area under the Receiver Operator Characteristic (AU-ROC) curve.
In comparison with adolescents with Swedish-born mothers, adolescents with mothers born in upper-middle, lower-middle and low-income countries were less likely to use psychotropic medication. However, the variance between MCOBs was small (ICC = 2.5 in the final model) relative to the variation within MCOBs. This was confirmed by an AU-ROC value of 0.598.
Even though we found associations between MCOB and adolescent use of psychotropic medication, the small ICC and AU-ROC indicate that MCOB appears to be an inaccurate context for discriminating adolescent use of psychotropic medication in Sweden.
Notes
ErratumIn: Ethn Health. 2016 Dec;21(6):i PMID 26965376
PubMed ID
26884047 View in PubMed
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Appropriate assessment of ethnic differences in adolescent use of psychotropic medication: multilevel analysis of discriminatory accuracy.

https://arctichealth.org/en/permalink/ahliterature289724
Source
Ethn Health. 2016 12; 21(6):578-95
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
12-2016
Author
Anna-Karin Ivert
Shai Mulinari
Willemijn van Leeuwen
Philippe Wagner
Juan Merlo
Author Affiliation
a Faculty of Medicine, Unit for Social Epidemiology , CRC, Skåne University Hospital, Lund University , Malmö , Sweden.
Source
Ethn Health. 2016 12; 21(6):578-95
Date
12-2016
Language
English
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Developing Countries
Drug Utilization - statistics & numerical data
Female
Humans
Male
Mothers - statistics & numerical data
Multilevel Analysis
Psychotropic Drugs - economics - therapeutic use
ROC Curve
Registries
Risk factors
Socioeconomic Factors
Sweden - epidemiology
Young Adult
Abstract
In the present study, we used a multilevel approach to investigate the role of maternal country of birth (MCOB) in predicting adolescent use of psychotropic medication in Sweden.
Using the Swedish Medical Birth Register we identified all 428,314 adolescents born between 1987 and 1990 and who were residing in Sweden in the year they turned 18. We applied multilevel logistic regression analysis with adolescents (level 1) nested within MCOBs (level 2). Measures of association (odds ratio) and measures of variance (intra-class correlation (ICC)) were calculated, as well as the discriminatory accuracy by calculating the area under the Receiver Operator Characteristic (AU-ROC) curve.
In comparison with adolescents with Swedish-born mothers, adolescents with mothers born in upper-middle, lower-middle and low-income countries were less likely to use psychotropic medication. However, the variance between MCOBs was small (ICC = 2.5 in the final model) relative to the variation within MCOBs. This was confirmed by an AU-ROC value of 0.598.
Even though we found associations between MCOB and adolescent use of psychotropic medication, the small ICC and AU-ROC indicate that MCOB appears to be an inaccurate context for discriminating adolescent use of psychotropic medication in Sweden.
Notes
ErratumIn: Ethn Health. 2016 Dec;21(6):i PMID 26965376
PubMed ID
26884047 View in PubMed
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Association between Apgar scores of 7 to 9 and neonatal mortality and morbidity: population based cohort study of term infants in Sweden.

https://arctichealth.org/en/permalink/ahliterature300008
Source
BMJ. 2019 05 07; 365:l1656
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
05-07-2019
Author
Neda Razaz
Sven Cnattingius
K S Joseph
Author Affiliation
Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden neda.razaz@gmail.com.
Source
BMJ. 2019 05 07; 365:l1656
Date
05-07-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Apgar score
Body mass index
Educational Status
Female
Health Surveys
Humans
Infant
Infant Mortality - trends
Infant, Newborn
Infant, Newborn, Diseases - mortality
Male
Maternal Age
Mothers - statistics & numerical data
Odds Ratio
Pregnancy
Prospective Studies
Risk factors
Severity of Illness Index
Sweden - epidemiology
Term Birth
Time Factors
Young Adult
Abstract
To investigate associations between Apgar scores of 7, 8, and 9 (versus 10) at 1, 5, and 10 minutes, and neonatal mortality and morbidity.
Population based cohort study.
Sweden.
1?551?436 non-malformed live singleton infants, born at term (=37 weeks' gestation) between 1999 and 2016, with Apgar scores of =7 at 1, 5, and 10 minutes.
Infants with Apgar scores of 7, 8, and 9 at 1, 5, and 10 minutes were compared with those with an Apgar score of 10 at 1, 5, and 10 minutes, respectively.
Neonatal mortality and morbidity, including neonatal infections, asphyxia related complications, respiratory distress, and neonatal hypoglycaemia. Adjusted odds ratios (aOR), adjusted rate differences (aRD), and 95% confidence intervals were estimated.
Compared with infants with an Apgar score of 10, aORs for neonatal mortality, neonatal infections, asphyxia related complications, respiratory distress, and neonatal hypoglycaemia were higher among infants with lower Apgar scores, especially at 5 and 10 minutes. For example, the aORs for respiratory distress for an Apgar score of 9 versus 10 were 2.0 (95% confidence interval 1.9 to 2.1) at 1 minute, 5.2 (5.1 to 5.4) at 5 minutes, and 12.4 (12.0 to 12.9) at 10 minutes. Compared with an Apgar score of 10 at 10 minutes, the aRD for respiratory distress was 9.5% (95% confidence interval 9.2% to 9.9%) for an Apgar score of 9 at 10 minutes, and 41.9% (37.7% to 46.4%) for an Apgar score of 7 at 10 minutes. A reduction in Apgar score from 10 at 5 minutes to 9 at 10 minutes was also associated with higher odds of neonatal morbidity, compared with a stable Apgar score of 10 at 5 and 10 minutes.
In term non-malformed infants with Apgar scores within the normal range (7 to 10), risks of neonatal mortality and morbidity are higher among infants with lower Apgar score values, and also among those experiencing a reduction in score from 5 minutes to 10 minutes (compared with infants with stable Apgar scores of 10).
PubMed ID
31064770 View in PubMed
Less detail

The association between BMI and mortality using offspring BMI as an indicator of own BMI: large intergenerational mortality study.

https://arctichealth.org/en/permalink/ahliterature146555
Source
BMJ. 2009;339:b5043
Publication Type
Article
Date
2009
Author
George Davey Smith
Jonathan A C Sterne
Abigail Fraser
Per Tynelius
Debbie A Lawlor
Finn Rasmussen
Author Affiliation
Medical Research Council Centre for Causal Analyses in Translational Epidemiology, Department of Social Medicine, University of Bristol, Bristol, BS8 2BN.
Source
BMJ. 2009;339:b5043
Date
2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Body mass index
Cause of Death
Fathers - statistics & numerical data
Female
Follow-Up Studies
Humans
Male
Middle Aged
Mothers - statistics & numerical data
Nuclear Family
Proportional Hazards Models
Prospective Studies
Sweden - epidemiology
Young Adult
Abstract
To obtain valid estimates of the association between body mass index (BMI) and mortality by using offspring BMI as an instrumental variable for own BMI.
Cohort study based on record linkage, with 50 years of follow-up for mortality. Associations of offspring BMI with all cause and cause specific maternal and paternal mortality were estimated as hazard ratios per standard deviation of offspring BMI.
A large intergenerational prospective population based database covering the general population of Sweden.
More than one million Swedish parent-son pairs.
The final dataset analysed contained information on 1 018 012 mother-son pairs (122 677 maternal deaths) and 1 004 617 father-son pairs (242 126 paternal deaths). For some causes of death, the patterns of associations between offspring BMI and mortality were similar to those seen for own BMI and mortality in previous studies. Parental mortality from diabetes, coronary heart disease, and kidney cancer had the strongest positive associations with offspring BMI (for example, hazard ratio (HR) for coronary heart disease per standard deviation increase in offspring BMI for mothers 1.15, 95% CI 1.14 to 1.17 and for fathers 1.10, 1.09 to 1.11). However, in contrast to the inverse association of own BMI with lung cancer and respiratory disease mortality seen in other studies, there was a positive association between offspring BMI and lung cancer mortality in mothers (1.12, 1.09 to 1.15) and fathers (1.03, 1.02 to 1.05) and between offspring BMI and respiratory mortality in mothers (1.05, 1.02 to 1.08) and fathers (1.02, 1.00 to 1.04). Associations of own BMI and offspring BMI with all cause, cardiovascular disease related, and non-cardiovascular disease related mortality were compared in a subset of father-son pairs (n=72 815). When offspring BMI was used as an instrumental variable for paternal BMI, the causal association between BMI and paternal cardiovascular disease mortality (HR per standard deviation of BMI 1.82, 95% CI 1.17 to 2.83) was stronger than that indicated by the directly observed association between own BMI and cardiovascular disease mortality (1.45, 1.31 to 1.61).
Use of offspring BMI as a predictor of own BMI, a technique that avoids problems of reverse causality, suggests that positive associations of BMI with all cause and cardiovascular mortality may be underestimated in conventional observational studies. Use of offspring BMI instead of own BMI in analyses of respiratory disease and lung cancer mortality, for which previous studies have reported consistent and strong inverse associations with own BMI, suggests that such studies have overstated the apparent adverse consequences of lower BMI with respect to these outcomes.
Notes
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PubMed ID
20028778 View in PubMed
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Association between immigrant background and ADHD: a nationwide population-based case-control study.

https://arctichealth.org/en/permalink/ahliterature286196
Source
J Child Psychol Psychiatry. 2016 Aug;57(8):967-75
Publication Type
Article
Date
Aug-2016
Author
Venla Lehti
Roshan Chudal
Auli Suominen
Mika Gissler
Andre Sourander
Source
J Child Psychol Psychiatry. 2016 Aug;57(8):967-75
Date
Aug-2016
Language
English
Publication Type
Article
Keywords
Adult
Attention Deficit Disorder with Hyperactivity - epidemiology
Case-Control Studies
Child
Emigrants and Immigrants - statistics & numerical data
Fathers - statistics & numerical data
Female
Finland - epidemiology
Humans
Male
Mothers - statistics & numerical data
Registries - statistics & numerical data
Abstract
Information about psychiatric disorders among those with immigrant parents is important for early detection and service development. The aim of this study is to examine the association between parental immigration and the diagnosis of attention-deficit hyperactivity disorder (ADHD) in offspring in Finland.
This matched case-control study was based on a national birth cohort. The sample included all singletons who were born in Finland in 1991-2005 and diagnosed with ADHD by the year 2011 (n = 10,409) and their matched controls (n = 39,124). Nationwide registers were used to identify participants and to gather information on the parents' country of birth and native language. Conditional logistic regression analyses were conducted using maternal and paternal migration status and region of birth as well as time since maternal migration as exposure factors.
The likelihood of being diagnosed with ADHD was significantly increased among children of two immigrant parents [adjusted odds ratio (aOR) 4.7, 95% CI 3.4-6.6] and children of an immigrant father (aOR 1.9, 95% CI 1.6-2.2). The likelihood of receiving an ADHD diagnosis was equal among children whose mother was a recent immigrant when she gave birth and those whose mother had stayed in Finland at least for a year before birth. The association between parental migration and ADHD diagnosis was strongest among fathers born in sub-Saharan Africa or Latin America and among mothers born in sub-Saharan Africa or North Africa and Middle East. Children, whose parents were born in countries with low Human Development Index (HDI), were more often diagnosed with ADHD.
The increased likelihood of ADHD diagnosis among children of immigrants indicates increased exposure to environmental risk factors, differences in the use of health services, or challenges in diagnosing immigrants' children.
PubMed ID
27133554 View in PubMed
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Association between offspring intelligence and parental mortality: a population-based cohort study of one million Swedish men and their parents.

https://arctichealth.org/en/permalink/ahliterature92789
Source
J Epidemiol Community Health. 2008 Aug;62(8):722-7
Publication Type
Article
Date
Aug-2008
Author
Modig-Wennerstad K.
Silventoinen K.
Batty D.
Tynelius P.
Bergman L.
Rasmussen F.
Author Affiliation
Department of Public Health Sciences, Karolinska Institute, Norrbacka, SE-171 76 Stockholm, Sweden.
Source
J Epidemiol Community Health. 2008 Aug;62(8):722-7
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Epidemiologic Methods
Fathers - statistics & numerical data
Female
Humans
Intelligence - genetics
Male
Mortality
Mothers - statistics & numerical data
Parents
Social Environment
Sweden - epidemiology
Abstract
BACKGROUND: An inverse association of IQ with mortality has been observed in previous studies. Analyses of associations between offspring's IQ and parental mortality in biological and non-biological family relations may shed light on genetic and environmental influences. METHODS: In a target cohort of 1,235,375 Swedish men, 931,825 (75%) men had complete data on all variables used. IQ of offspring was measured at age 18 and mothers and father were followed, on average, for 21.2 years and 19.7 years, respectively, with respect to all-cause and cause-specific mortality (cardiovascular disease, coronary heart disease, stroke and diabetes). The analyses were conducted by proportional hazards regression with adjustment for parental occupation, education and income. RESULTS: In adjusted analyses using IQ as a continuous variable over a standard nine-point scale, hazards ratio (HR) for all-cause mortality was 0.96 (95% CI 0.96 to 0.96) for fathers and 0.95 (0.95 to 0.95) for mothers. The corresponding HRs were 0.99 (0.97 to 1.00) for step-fathers and 0.97 (0.95 to 0.99) for step-mothers. In adjusted analyses, HRs for CVD mortality among fathers and mothers were 0.97 (0.96 to 0.97) and 0.94 (0.93 to 0.94) respectively. The corresponding HRs for diabetes mortality were 0.91 (0.89 to 0.92) among fathers and 0.85 (0.83 to 0.87) among mothers. CONCLUSIONS: The associations found in non-biological family relationships suggest shared environmental influences and/or assortative mating. Stronger IQ-mortality associations in biological than non-biological relationships suggest genetic influences. Stronger inverse offspring IQ-parental mortality associations in mothers than in fathers might be due to environmental factors or epigenetic mechanisms.
PubMed ID
18621958 View in PubMed
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The association between prescribed opioid use for mothers and children: a record-linkage study.

https://arctichealth.org/en/permalink/ahliterature123599
Source
Eur J Clin Pharmacol. 2013 Jan;69(1):111-8
Publication Type
Article
Date
Jan-2013
Author
Tomas Log
Svetlana Skurtveit
Randi Selmer
Aage Tverdal
Kari Furu
Ingeborg Hartz
Author Affiliation
Department of Pharmacy, University of Tromsø, 9037 Tromsø, Norway. tomas.log@uit.no
Source
Eur J Clin Pharmacol. 2013 Jan;69(1):111-8
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Analgesics, Opioid - therapeutic use
Databases, Factual
Female
Humans
Male
Middle Aged
Mothers - statistics & numerical data
Norway
Registries
Abstract
The repeated use of prescription opioids may lead to serious side effects. It is therefore important to examine factors associated with such repeated use. The aim of this study was to investigate the association between the maternal use of prescription opioids and their use by offspring of these mothers.
Data were extracted from two nationwide registers linked by unique personal identity numbers: the 2001 Norwegian Population and Housing Census and the Norwegian Prescription Database 2004-2009. The study population consisted of 97,574 adolescents aged 15-16 years in 2001 and their mothers. The repeated use of opioids was defined as the issuing of >4 and >15 prescriptions to an adolescent and his/her mother, respectively, during the period 2004-2009. Non-steroidal anti-inflammatory drugs (NSAIDs) are not potentially addictive, and individuals issued prescriptions for NSAIDs were used as the reference analgesic drug group.
The proportion of repeated prescription opioid users was higher among adolescents whose mother was registered as a repeated user of prescription opioids (8.4 %) than among those whose mother did not repeatedly use prescription opioids (2.4 %). The odds ratio (OR) was 3.1 [95 % confidence interval (CI) 2.7-3.6] when adjusted for the mother's socioeconomic characteristics and the gender of the offspring. A lower socioeconomic position of the mother increased the risk of repeated opioid use by her offspring. Maternal repeated use of NSAIDs was associated with repeated use of NSAIDs among offspring (OR 1.8, 95 % CI 1.7-2.0).
Among our study population, the maternal use of opioids was associated with the repeated use of prescription opioids among the respective offspring. The same association was seen with NSAIDs, but to a lesser extent.
PubMed ID
22684128 View in PubMed
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Association Between the Birth of an Infant With Major Congenital Anomalies and Subsequent Risk of Mortality in Their Mothers.

https://arctichealth.org/en/permalink/ahliterature280786
Source
JAMA. 2016 12 20;316(23):2515-2524
Publication Type
Article
Date
12-20-2016
Author
Eyal Cohen
Erzsébet Horváth-Puhó
Joel G Ray
Lars Pedersen
Nancy Adler
Anne Gulbech Ording
Paul H Wise
Arnold Milstein
Henrik Toft Sørensen
Source
JAMA. 2016 12 20;316(23):2515-2524
Date
12-20-2016
Language
English
Publication Type
Article
Keywords
Adult
Cause of Death
Cohort Studies
Congenital Abnormalities - epidemiology
Denmark - epidemiology
Female
Humans
Infant
Middle Aged
Mortality - trends
Mothers - statistics & numerical data
Pregnancy
Registries
Risk
Abstract
Giving birth to a child with a major birth defect is a serious life event for a woman, yet little is known about the long-term health consequences for the mother.
To assess whether birth of an infant born with a major congenital anomaly was associated with higher maternal risk of mortality.
This population-based cohort study (n?=?455?250 women) used individual-level linked Danish registry data for mothers who gave birth to an infant with a major congenital anomaly (41?508) between 1979 and 2010, with follow-up until December 31, 2014. A comparison cohort (413?742) was constructed by randomly sampling, for each mother with an affected infant, up to 10 mothers matched on maternal age, parity, and year of infant's birth.
Live birth of an infant with a major congenital anomaly as defined by the European Surveillance of Congenital Anomalies classification system.
Primary outcome was all-cause mortality. Secondary outcomes included cause-specific mortality. Hazard ratios (HRs) were adjusted for marital status, immigration status, income quartile (since 1980), educational level (since 1981), diabetes mellitus, modified Charlson comorbidity index score, hypertension, depression, history of alcohol-related disease, previous spontaneous abortion, pregnancy complications, smoking (since 1991), and body mass index (since 2004).
Mothers in both groups were a mean (SD) age of 28.9 (5.1) years at delivery. After a median (IQR) follow-up of 21 (12-28) years, there were 1275 deaths (1.60 per 1000 person-years) among 41?508 mothers of a child with a major congenital anomaly vs 10?112 deaths (1.27 per 1000 person-years) among 413?742 mothers in the comparison cohort, corresponding to an absolute mortality rate difference of 0.33 per 1000 person-years (95% CI, 0.24-0.42), an unadjusted HR of 1.27 (95% CI, 1.20-1.35), and an adjusted HR of 1.22 (95% CI, 1.15-1.29). Mothers with affected infants were more likely to die of cardiovascular disease (rate difference, 0.05 per 1000 person-years [95% CI, 0.02-0.08]; adjusted HR, 1.26 [95% CI, 1.04-1.53]), respiratory disease (rate difference, 0.02 per 1000 person-years [95% CI, 0.00-0.04]; adjusted HR, 1.45 [95% CI, 1.01-2.08]), and other natural causes (rate difference, 0.11 per 1000 person-years [95% CI, 0.07-0.15]; adjusted HR, 1.50 [95% CI, 1.27-1.76]).
In Denmark, having a child with a major congenital anomaly was associated with a small but statistically significantly increased mortality risk in the mother compared with women without an affected child. However, the clinical importance of this association is uncertain.
PubMed ID
27997654 View in PubMed
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