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0000-0003-3740-8117
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Curtin University
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Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.SCITOTENV.2016.11.147
Abstract: Although studies have examined the associations between fine particles (PM
Publisher: Wiley
Date: 04-09-2016
Abstract: To compare chief complaints of the Medical Priority Dispatch System in terms of the match between dispatch priority and patient condition. This was a retrospective whole-of-population study of emergency ambulance dispatch in Perth, Western Australia, 1 January 2014 to 30 June 2015. Dispatch priority was categorised as either Priority 1 (high priority), or Priority 2 or 3. Patient condition was categorised as time-critical for patient(s) transported as Priority 1 to hospital or who died (and resuscitation was attempted by paramedics) else, patient condition was categorised as less time-critical. The χ There were 211 473 cases of dispatch. Of 99 988 cases with Priority 2 or 3 dispatch, 467 (0.5%) were time-critical. Convulsions/seizures and breathing problems were highlighted as having more false negatives (time-critical despite Priority 2 or 3 dispatch) than expected from the overall false omission rate. Of 111 485 cases with Priority 1 dispatch, 6520 (5.8%) were time-critical. Our analysis highlighted chest pain, heart problems/automatic implanted cardiac defibrillator, unknown problem/collapse, and headache as having fewer true positives (time-critical and Priority 1 dispatch) than expected from the overall positive predictive value. Scope for reducing under-triage and over-triage of ambulance dispatch varies between chief complaints of the Medical Priority Dispatch System. The highlighted chief complaints should be considered for future research into improving ambulance dispatch system performance.
Publisher: Elsevier BV
Date: 07-2013
Publisher: Public Library of Science (PLoS)
Date: 10-05-2023
DOI: 10.1371/JOURNAL.PONE.0285568
Abstract: The risk of preterm birth (PTB) and low birthweight (LBW) may change over time the longer that immigrants reside in their adopted countries. We aimed to study the influence of acculturation on the risk of these outcomes in Australia. A retrospective cohort study using linked health data for all non-Indigenous births from 2005–2013 in Western Australia was undertaken. Acculturation was assessed through age on arrival, length of residence, interpreter use and having an Australian-born partner. Adjusted odds ratios (aOR) for term-LBW and PTB (all, spontaneous, medically-indicated) were calculated using multivariable logistic regression in migrants from six ethnicities (white, Asian, Indian, African, Māori, and ‘other’) for different levels of acculturation, compared to the Australian-born population as the reference. The least acculturated migrant women, those from non-white non-Māori ethnic backgrounds who immigrated at age ≥18 years, had an overseas-born partner, lived in Australia for 5 years and used a paid interpreter, had 58% (aOR 1.58, 95% CI 1.15–2.18) higher the risk of term-LBW and 40% (aOR 0.60, 95% CI 0.45–0.80) lower risk of spontaneous PTB compared to the Australian-born women. The most acculturated migrant women, those from non-white non-Māori ethnic backgrounds who immigrated at age years, had an Australian-born partner, lived in Australia for 10 years and did not use an interpreter, had similar risk of term-LBW but 43% (aOR 1.43, 95% CI 1.14–1.78) higher risk of spontaneous PTB than the Australian-born women. Acculturation is an important factor to consider when providing antenatal care to prevent PTB and LBW in migrants. Acculturation may reduce the risk of term-LBW but, conversely, may increase the risk of spontaneous PTB in migrant women residing in Western Australia. However, the effect may vary by ethnicity and warrants further investigation to fully understand the processes involved.
Publisher: Wiley
Date: 06-04-2022
DOI: 10.1111/DAR.13467
Abstract: After a first alcohol‐related hospitalisation in youth, subsequent hospitalisations may demonstrate an increased risk of further alcohol‐related hospitalisations, but there is no existing data on this. A retrospective longitudinal study between July 1992 and June 2017 using linked hospital administrative data identified 23 464 Western Australian young people [9009 (38.4%) females and 14 455 (61.6%) males], aged 12–24 years hospitalised for at least one alcohol‐related harm (ARH) episode of care. Cox regression was used to estimate hazard ratios (HR) between risk factors and repeated alcohol‐related hospitalisation after the first discharge for ARH. Of those admitted for an alcohol‐related hospitalisation ( n = 23 464), 21% ( n = 4996) were readmitted for ARH. This high‐risk sub‐group comprised 46% ( n = 16 017) of the total alcohol‐related admissions ( n = 34 485). After the first discharge for ARH, 16% (804) of people who experienced an alcohol‐related readmission were readmitted within 1 month, and 51.8% (2589) were readmitted within 12 months. At increased risk of readmission were Aboriginal people and those with prior health service contacts occurring before their first alcohol‐related hospitalisation, including illicit drug hospitalisations, mental health contacts and, in a sub‐analysis, emergency department presentations. The probability of a repeated ARH hospitalisation was highest in the first month after initial discharge. There is a high‐risk sub‐group of young people more likely to have a repeat ARH hospitalisation. This represents an opportunity to provide interventions to those most at risk of repeated ARH.
Publisher: Wiley
Date: 23-08-2021
DOI: 10.1002/AUR.2599
Abstract: It is biologically plausible that risk of autism spectrum disorder (ASD) is elevated by both short and long interpregnancy intervals (IPI). We conducted a retrospective cohort study of singleton, non‐nulliparous live births, 1998–2007 in Denmark, Finland, and Sweden ( N = 925,523 births). Optimal IPI was defined as the IPI at which minimum risk was observed. Generalized additive models were used to estimate relative risks (RR) of ASD and 95% Confidence Intervals (CI). Population impact fractions (PIF) for ASD were estimated under scenarios for shifts in the IPI distribution. We observed that the association between ASD ( N = 9302) and IPI was U‐shaped for all countries. ASD risk was lowest (optimal IPI) at 35 months for all countries combined, and at 30, 33, and 39 months in Denmark, Finland, and Sweden, respectively. Fully adjusted RRs at IPIs of 6, 12, and 60 months were 1.41 (95% CI: 1.08, 1.85), 1.26 (95% CI: 1.02, 1.56), and 1.24 (95% CI: 0.98, 1.58) compared to an IPI of 35 months. Under the most conservative scenario PIFs ranged from 5% (95% CI: 1%–8%) in Denmark to 9% (95% CI: 6%–12%) in Sweden. The minimum ASD risk followed IPIs of 30–39 months across three countries. These results reflect both direct IPI effects and other, closely related social and biological pathways. If our results reflect biologically causal effects, increasing optimal IPIs and reducing their indications, such as unintended pregnancy and delayed age at first pregnancy has the potential to prevent a salient proportion of ASD cases. Waiting 35 months to conceive again after giving birth resulted in the least risk of autism. Shorter and longer intervals resulted in risks that were up to 50% and 85% higher, respectively. About 5% to 9% of autism cases might be avoided by optimizing birth spacing.
Publisher: SAGE Publications
Date: 28-10-2015
Abstract: A systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach evaluating Botulinum Toxin type A efficacy on improving ease of care in the upper/lower limb. Pubmed, Cinahl, Amed, Embase and Cochrane databases. English Language. Search to July 2014. All randomized, placebo controlled trials on adults with difficulty in caring for the upper/lower limb resulting from spasticity of any origin and treated with a single dose of Botulinum Toxin A. Evidence quality was assessed by GRADE. A total of 32 studies were reviewed. Meta-analysis was carried out on 11 upper limb and three lower limb studies. Evidence quality for the upper limb was moderate. A significant result for Botulinum Toxin A was found at four to 12 weeks for the upper limb (SMD 0.80, CI 0.55, 1.06, p 0.0001). The effects were maintained for up to six months (SMD 0.48, CI 0.34, 0.62, p 0.0001). Evidence quality was very low for the lower limb. Meta-analysis was only possible for global assessment of benefit. No significant effect was found. (Patient: RR 1.37 CI (0.94, 2.00) p = 0.11 clinician: RR 1.06 (0.84, 1.34) p = 0.60.) Botulinum Toxin A improves ease of care in the upper limb for up to six months. No conclusion can be drawn for the lower limb.
Publisher: BMJ
Date: 2013
Publisher: Elsevier BV
Date: 2015
Publisher: Elsevier BV
Date: 04-2023
Publisher: AMPCo
Date: 05-2013
DOI: 10.5694/MJA12.11539
Abstract: To examine the association between tobacco outlet density and area socioeconomic status (SES) in Western Australia. Ecological cross-sectional study investigating the relationship between the area SES of, and the density of tobacco retail outlets in, WA suburbs and towns for the Perth metropolitan area, and at the regional and state level. SES was determined using the 2006 Australian Bureau of Statistics Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) and classified into quartiles (very low, low, high and very high) tobacco outlet data were sourced from the WA Department of Health register of retailers licensed to sell tobacco at May 2011. Tobacco outlet density rate (per 10 000 residents). In WA overall, suburbs and towns with a very low IRSAD had more than four times the number of tobacco outlets compared with those with a very high IRSAD (P> < 0.001). This study provides the first Australian evidence of a strong relationship between area SES and tobacco outlet density. Findings are consistent with a number of United States studies that report higher tobacco outlet densities in lower SES or minority neighbourhoods. The results underscore the importance of policy approaches to limit the number of tobacco retail licences granted, and to reduce the geographic density of outlets in more disadvantaged suburbs and towns.
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.SCITOTENV.2016.11.025
Abstract: Biomass burning (BB) is a significant air pollution source, with global, regional and local impacts on air quality, public health and climate. Worldwide an extensive range of studies has been conducted on almost all the aspects of BB, including its specific types, on quantification of emissions and on assessing its various impacts. China is one of the countries where the significance of BB has been recognized, and a lot of research efforts devoted to investigate it, however, so far no systematic reviews were conducted to synthesize the information which has been emerging. Therefore the aim of this work was to comprehensively review most of the studies published on this topic in China, including literature concerning field measurements, laboratory studies and the impacts of BB indoors and outdoors in China. In addition, this review provides insights into the role of wildfire and anthropogenic BB on air quality and health globally. Further, we attempted to provide a basis for formulation of policies and regulations by policy makers in China.
Publisher: Springer Science and Business Media LLC
Date: 21-06-2012
Publisher: American Academy of Pediatrics (AAP)
Date: 02-2016
Abstract: Undescended testis (UDT) is the most common genital anomaly in boys. Current guidelines recommend surgery before 12 months of age to maximize fertility and potentially reduce the risk of future malignancy. We investigated the prevalence of UDT and examined rates of surgery and age at surgery in an Australian population. UDT was identified from all live-born infants in New South Wales, Australia, from 2001 to 2011 using routinely collected record-linked birth and hospital data. The prevalence of UDT, surgery rates, age at surgery, postsurgical outcomes, and risk factors for surgery performed later than the recommended age were evaluated. There were 10 875 (2.1%) boys with a recorded diagnosis of UDT. Corrective surgery was performed in 4980 (45.8%), representing a cumulative prevalence of 9.6 per 1000 male births. Five percent of surgeries were orchidectomies, and 9% of boys had revision surgery. Median age at surgery was 16.6 months (interquartile range 11.8 to 31.0 months), decreasing from 21 months for boys born in 2001 to 13 months for boys born in 2010. Among those boys having surgery before 36 months (n = 3897), 67% had corrective surgery after the recommended 12 months of age socioeconomic disadvantage, regional/remote area of residence, and lack of private health insurance were risk factors for having corrective surgery after 12 months. One in 50 boys born are diagnosed with UDT two-thirds had no report of corrective surgery. The age at surgery is decreasing however, two-thirds of surgeries are performed after 12 months of age.
Publisher: Public Library of Science (PLoS)
Date: 22-01-2021
DOI: 10.1371/JOURNAL.PONE.0245935
Abstract: To evaluate gestational age as a predictor of subsequent preterm birth. This was a retrospective birth cohort study to evaluate gestational age as a predictor of subsequent preterm birth. Participants were mothers who gave birth to their first two children in Western Australia, 1980–2015 (N = 255,151 mothers). For each week of final gestational age of the first birth, we calculated relative risks (RR) and absolute risks (AR) of subsequent preterm birth defined as final gestational age before 28, 32, 34 and weeks. Risks were unadjusted to preserve risk factor profiles at each week of gestation. The relative risks of second birth before 28, 32, and 34 weeks’ gestation were all approximately twenty times higher for mothers whose first birth had a gestational age of 22 to 30 weeks compared to those whose first birth was at 40 weeks’ gestation. The absolute risks of second birth before 28, 32, and 34 weeks’ gestation for these mothers had upper confidence limits that were all less than 16.74%. The absolute risk of second birth before 37 weeks was highest at 32.11% (95% CI: 30.27, 34.02) for mothers whose first birth was 22 to 30 weeks’ gestation. For all gestational ages of the first child, the lowest quartile and median gestational age of the second birth were at least 36 weeks and at least 38 weeks, respectively. Sensitivity and positive predictive values were all below 35%. Relative risks of early subsequent birth increased markedly with decreasing gestational age of the first birth. However, absolute risks of clinically significant preterm birth ( weeks, weeks, weeks), sensitivity and positive predictive values remained low. Early gestational age is a strong risk factor but a poor predictor of subsequent preterm birth.
Publisher: American Chemical Society (ACS)
Date: 02-10-2018
Abstract: Australia has relatively erse sources and low concentrations of ambient fine particulate matter (<2.5 μm, PM
Publisher: Public Library of Science (PLoS)
Date: 22-11-2022
DOI: 10.1371/JOURNAL.PMED.1004129
Abstract: The World Health Organization recommends to wait at least 6 months after miscarriage and induced abortion before becoming pregnant again to avoid complications in the next pregnancy, although the evidence-based underlying this recommendation is scarce. We aimed to investigate the risk of adverse pregnancy outcomes—preterm birth (PTB), spontaneous PTB, small for gestational age (SGA) birth, large for gestational age (LGA) birth, preecl sia, and gestational diabetes mellitus (GDM)—by interpregnancy interval (IPI) for births following a previous miscarriage or induced abortion. We conducted a cohort study using a total of 49,058 births following a previous miscarriage and 23,707 births following a previous induced abortion in Norway between 2008 and 2016. We modeled the relationship between IPI and 6 adverse pregnancy outcomes separately for births after miscarriages and births after induced abortions. We used log-binomial regression to estimate unadjusted and adjusted relative risk (aRR) and 95% confidence intervals (CIs). In the adjusted model, we included maternal age, gravidity, and year of birth measured at the time of the index (after interval) births. In a sensitivity analysis, we further adjusted for smoking during pregnancy and prepregnancy body mass index. Compared to births with an IPI of 6 to 11 months after miscarriages (10.1%), there were lower risks of SGA births among births with an IPI of months (8.6%) (aRR 0.85, 95% CI: 0.79, 0.92, p 0.01) and 3 to 5 months (9.0%) (aRR 0.90, 95% CI: 0.83, 0.97, p = 0.01). An IPI of months after a miscarriage (3.3%) was also associated with lower risk of GDM (aRR 0.84, 95% CI: 0.75, 0.96, p = 0.01) as compared to an IPI of 6 to 11 months (4.5%). For births following an induced abortion, an IPI months (11.5%) was associated with a nonsignificant but increased risk of SGA (aRR 1.16, 95% CI: 0.99, 1.36, p = 0.07) as compared to an IPI of 6 to 11 months (10.0%), while the risk of LGA was lower among those with an IPI 3 to 5 months (8.0%) (aRR 0.84, 95% CI: 0.72, 0.98, p = 0.03) compared to an IPI of 6 to 11 months (9.4%). There was no observed association between adverse pregnancy outcomes with an IPI months after either a miscarriage or induced abortion ( p 0.05), with the exception of an increased risk of GDM among women with an IPI of 12 to 17 months (5.8%) (aRR 1.20, 95% CI: 1.02, 1.40, p = 0.02), 18 to 23 months (6.2%) (aRR 1.24, 95% CI: 1.02, 1.50, p = 0.03), and ≥24 months (6.4%) (aRR 1.14, 95% CI: 0.97, 1.34, p = 0.10) compared to an IPI of 6 to 11 months (4.5%) after a miscarriage. Inherent to retrospective registry-based studies, we did not have information on potential confounders such as pregnancy intention and health-seeking bahaviour. Furthermore, we only had information on miscarriages that resulted in contact with the healthcare system. Our study suggests that conceiving within 3 months after a miscarriage or an induced abortion is not associated with increased risks of adverse pregnancy outcomes. In combination with previous research, these results suggest that women could attempt pregnancy soon after a previous miscarriage or induced abortion without increasing perinatal health risks.
Publisher: Public Library of Science (PLoS)
Date: 19-07-2021
DOI: 10.1371/JOURNAL.PONE.0255000
Abstract: Most evidence for interpregnancy interval (IPI) and adverse birth outcomes come from studies that are prone to incomplete control for confounders that vary between women. Comparing pregnancies to the same women can address this issue. We conducted an international longitudinal cohort study of 5,521,211 births to 3,849,193 women from Australia (1980–2016), Finland (1987–2017), Norway (1980–2016) and the United States (California) (1991–2012). IPI was calculated based on the time difference between two dates—the date of birth of the first pregnancy and the date of conception of the next (index) pregnancy. We estimated associations between IPI and preterm birth (PTB), spontaneous PTB, and small-for-gestational age births (SGA) using logistic regression (between-women analyses). We also used conditional logistic regression comparing IPIs and birth outcomes in the same women (within-women analyses). Random effects meta-analysis was used to calculate pooled adjusted odds ratios (aOR). Compared to an IPI of 18–23 months, there was insufficient evidence for an association between IPI months and overall PTB (aOR 1.08, 95% CI 0.99–1.18) and SGA (aOR 0.99, 95% CI 0.81–1.19), but increased odds of spontaneous PTB (aOR 1.38, 95% CI 1.21–1.57) in the within-women analysis. We observed elevated odds of all birth outcomes associated with IPI ≥60 months. In comparison, between-women analyses showed elevated odds of adverse birth outcomes for month and month IPIs. We found consistently elevated odds of adverse birth outcomes following long IPIs. IPI shorter than 6 months were associated with elevated risk of spontaneous PTB, but there was insufficient evidence for increased risk of other adverse birth outcomes. Current recommendations of waiting at least 24 months to conceive after a previous pregnancy, may be unnecessarily long in high-income countries.
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.PUHE.2022.02.017
Abstract: Family planning counselling at different contact points of maternal health services has been recommended for increasing the uptake of modern contraceptive methods. However, studies from sub-Saharan Africa (SSA) demonstrated inconsistent findings. The aim of this systematic review was to synthesise the available current evidence for the association between family planning counselling and postpartum modern contraceptive uptake in SSA. This is a systematic review of the SSA literature. On 11 February 2021, we searched six electronic databases for studies published in English. We included quantitative observational and interventional studies that assessed the effects of family planning counselling on contraceptive uptake among women who gave birth in the first 12 months. We used Joanna Briggs Institute critical appraisal tools to evaluate study quality. The protocol for this systematic review was registered in PROSPERO (CRD42021234785). Twenty-seven studies with 26,814 participants comprising 18 observational and nine interventional studies were included. Family planning counselling during antenatal care, delivery, postnatal care, and antenatal and postnatal care was associated with postpartum contraceptive uptake. Moreover, the newly implemented family planning counselling interventions improved postpartum modern contraceptive uptake. Overall, the evidence suggests that family planning counselling during the different maternal health service delivery points enhances contraceptive uptake among postpartum women. SSA countries should promote and strengthen family planning counselling integrated with maternal health services, which will play a significant role in combating unintended and closely spaced pregnancies.
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.HEALTHPLACE.2009.09.006
Abstract: One of the major challenges in health studies with a spatial dimension is to produce valid and meaningful geographical representations of risk. This issue has arisen in our research on childhood asthma and proximity to traffic in Perth, Western Australia. To illustrate the spatial variation in risk over the study area, we developed a method for constructing a "risk field" map and applied this method to our study population. Cases and controls aged 0-19 years were defined using emergency department presentations from 2002 to 2006. For each asthma case, two matched controls were obtained. Geocoded residential addresses were used to calculate "vectors" or arrows of risk across the study area. This allows a rapid interpretation, with the risk of asthma greatest in the direction of the head of the vector relative to the vector's tail. This approach clearly indicated that the risk of asthma presentation at hospital emergency departments is higher for children living closer to the major urban city centers. Application of our method to the study population suggests that the "vector" approach may be useful as an exploratory tool for the spatial investigation of risk of other health outcomes.
Publisher: Elsevier BV
Date: 05-2016
Publisher: Public Library of Science (PLoS)
Date: 03-08-2022
DOI: 10.1371/JOURNAL.PGPH.0000563
Abstract: Family planning counselling can help improve the postpartum modern contraceptive uptake. However, studies in Ethiopia indicate inconsistent effects of integrated family planning counselling on postpartum modern contraceptive uptake. This study aimed to determine the extent of family planning counselling and its role in improving postpartum contraceptive uptake among women in Ethiopia. We used the Performance Monitoring for Action (PMA) Ethiopia panel survey data, a community-based prospective cohort study. Randomly selected pregnant women were recruited at the baseline interview and followed by six weeks and six months postpartum. A weighted generalised linear model fitted with a Poisson distribution and a log link function was used to estimate the adjusted relative risk (aRR) and 95% Confidence Interval (CI) of modern contraceptive uptake. The coverages of family planning counselling provision during ANC, prior to discharge and child immunisation were 20%, 27% and 23%, respectively. The modern contraceptive uptakes by six weeks and six months postpartum were 18% and 36%, respectively. Family planning counselling prior to discharge from the facility was associated with increased modern contraceptive uptake by six weeks (aRR 1.25 95% CI 0.94, 1.65) and six months postpartum periods (aRR 1.07 95% CI 0.90, 1.27). Moreover, women who received family planning counselling during child immunisation were 35% more likely to use modern contraceptives by six months postpartum (aRR 1.35 % CI 1.12, 1.62). However, counselling during ANC visits was not associated with modern contraceptive uptake by either six weeks or six months postpartum. A significant proportion of women had missed the opportunity, and the postpartum modern contraceptive uptake was low. Despite these, family planning counselling prior to discharge from the facility and during child immunisation improved the postpartum modern contraceptive uptake. However, our finding revealed insufficient evidence that family planning counselling during ANC is associated with postpartum modern contraceptive uptake.
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1111/J.1753-6405.2011.00760.X
Abstract: This study, in a region with relatively low industrial activity, used a highly specific marker for traffic emissions, accounted for the inherent fetal growth potential, and used complete record linkage of births, midwife notifications, deaths, hospital morbidity and birth defect records. Clinical records were obtained for pregnancies between 2000 and 2006 in three areas of Perth, Western Australia (n=3,501). We used carbon monoxide as a marker for locally derived traffic emissions, and assessed exposure using the AusRoads dispersion model. Fetal growth was characterised by proportion of optimal birth weight and investigated using multivariate mixed-effects regression. Exposure in the third trimester was associated with a -0.49% (sd=0.23%) change in proportion of optimal birth weight per 10 μg/m(3) increase in locally derived traffic emissions. However, this result was confined to one of the three study areas due to elevated exposure misclassification among women in the other two areas. Among this group, a neonate who would have otherwise attained an optimal birth weight of 3.5 kg would be expected to be born 58 g lighter for an interquartile increase in third trimester exposure, which was approximately half of the effect observed for maternal smoking during pregnancy. We observed an association between maternal exposure to traffic emissions and reduced fetal growth. This effect was supported by sensitivity analyses but only observed in one of the three study areas. Further studies are required to corroborate our results.
Publisher: Wiley
Date: 19-03-2020
DOI: 10.1111/PPE.12668
Abstract: Despite extensive research on risk factors and mechanisms, the extent to which interpregnancy interval (IPI) affects hypertensive disorders of pregnancy in high‐income countries remains unclear. To examine the association between IPI and hypertensive disorders of pregnancy in a high‐income country setting using both within‐mother and between‐mother comparisons. A retrospective population‐based cohort study was conducted among 103 909 women who delivered three or more consecutive singleton births (n = 358 046) between 1980 and 2015 in Western Australia. We used conditional Poisson regression with robust variance, matching intervals of the same mother and adjusted for factors that vary within‐mother across pregnancies, to investigate the association between IPI categories (reference 18‐23 months), and the risk of hypertensive disorders of pregnancy. For comparison with previous studies, we also applied unmatched Poisson regression (between‐mother analysis). The incidence of preecl sia and gestational hypertension during the study period was 4%, and 2%, respectively. For the between‐mother comparison, mothers with intervals of 6‐11 months had lower risk of preecl sia with adjusted relative risk (RR) 0.92 (95% confidence interval [CI] 0.85, 0.98) compared to reference category of 18‐23 months. With the within‐mother matched design, we estimated a larger effect of long IPI on risk of preecl sia (RR 1.29, 95% CI 1.18, 1.42 for 60‐119 months and RR 1.30, 95% CI 1.10, 1.53 for intervals ≥120 months) compared to 18‐23 months. Short IPIs were not associated with hypertensive disorders of pregnancy. In our cohort, longer IPIs were associated with increased risk of preecl sia. However, there was insufficient evidence to suggest that short IPIs ( months) increase the risks of hypertensive disorders of pregnancy.
Publisher: Elsevier BV
Date: 2012
DOI: 10.1016/J.AJOG.2011.07.038
Abstract: We sought to investigate seasonal variation in fetal growth, accounting for important sociodemographic, biological, and environmental exposures. Records of births 1998 through 2006 in Perth, Western Australia were obtained (N = 147,357). We investigated small for gestational age and sex and the proportion of optimal birthweight (POBW) in relation to seasonal exposures (season, temperature, sunlight) by trimester of pregnancy. Adjustment was made for a wide range of risk factors. The POBW for neonates with third trimesters predominantly in summer was 0.18% (0.00-0.36%) lower than for those in winter. POBW decreased by 0.14% (0.01-0.27%) per interquartile range increase in third-trimester temperature (9.15°C). An interquartile range increase in temperature over pregnancy (0.73°C) was associated with an odds ratio of 1.02 (95% confidence interval, 1.00-1.05) for small for gestational age and sex. Reduced fetal growth was associated with elevated ambient temperatures throughout and late in pregnancy, independently of air pollution and other risk factors.
Publisher: Elsevier BV
Date: 10-2021
Publisher: BMJ
Date: 08-2018
DOI: 10.1136/BMJOPEN-2018-025008
Abstract: Interpregnancy interval (IPI) is the length of time between a birth and conception of the next pregnancy. Evidence suggests that both short and long IPIs are at increased risk of adverse pregnancy and perinatal outcomes. Relatively less attention has been directed towards investigating the effect of IPI on pregnancy complications, and the studies that have been conducted have shown mixed results. This systematic review will aim to provide an update to the most recent available evidence on the effect of IPI on pregnancy complications. We will search electronic databases such as Ovid/MEDLINE, EMBASE, CINAHL, Scopus, Web of Science and PubMed to identify peer-reviewed articles on the effects of IPI on pregnancy complications. We will include articles published from start of indexing until 12 February 2018 without any restriction to geographic setting. We will limit the search to literature published in English language and human subjects. Two independent reviewers will screen titles and abstracts and select full-text articles that meet the eligibility criteria. The Newcastle-Ottawa tool will be used to assess quality of observational studies. Where data permit, meta-analyses will be performed for in idual pregnancy complications. A subgroup analyses by country categories (high-income vs low and middle-income countries) based on World Bank income group will be performed. Where meta-analysis is not possible, we will provide a description of data without further attempt to quantitatively pool results. Formal ethical approval is not required as primary data will not be collected. The results will be published in peer-reviewed journals and presented at national and international conferences. CRD42018088578.
Publisher: Oxford University Press (OUP)
Date: 25-09-2013
DOI: 10.1093/AJE/KWT216
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.ENVPOL.2022.119465
Abstract: Multiple systematic reviews and meta-analyses linked prenatal exposure to ambient air pollutants to adverse birth outcomes with mixed findings, including results indicating positive, negative, and null associations across the pregnancy periods. The objective of this study was to systematically summarise systematic reviews and meta-analyses on air pollutants and birth outcomes to assess the overall epidemiological evidence. Systematic reviews with/without meta-analyses on the association between air pollutants (NO
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.IJHEH.2022.114029
Abstract: Epidemiologic evidence on acute heat and cold stress and preterm birth (PTB) is inconsistent and based on ambient temperature rather than a thermophysiological index. The aim of this study was to use a spatiotemporal thermophysiological index (Universal Thermal Climate Index, UTCI) to investigate prenatal acute heat and cold stress exposures and spontaneous PTB. We conducted a space-time-stratified case-crossover analysis of 15,576 singleton live births with spontaneous PTB between January 1, 2000 and December 31, 2015 in Western Australia. The association between UTCI and spontaneous PTB was examined with distributed lag nonlinear models and conditional quasi-Poisson regression. Relative to the median UTCI, there was negligible evidence for associations at the lower range of exposures (1st to 25th percentiles). We found positive associations in the 95th and 99th percentiles, which increased with increasing days of heat stress in the first week of delivery. The relative risk (RR) and 95% confidence interval (CI) for the immediate (delivery day) and cumulative short-term (up to six preceding days) exposures to heat stress (99th percentile, 31.2 °C) relative to no thermal stress (median UTCI, 13.8 °C) were 1.01 (95% CI: 1.01, 1.02) and 1.05 (95% CI: 1.04, 1.06), respectively. Elevated effect estimates for heat stress were observed for the transition season, the year 2005-2009, male infants, women who smoked, unmarried, ≤ 19 years old, non-Caucasians, and high socioeconomic status. Effect estimates for cold stress (1st percentile, 0.7 °C) were highest in the transition season, during 2005-2009, and for married, non-Caucasian, and high socioeconomic status women. Acute heat stress was associated with an elevated risk of spontaneous PTB with sociodemographic vulnerability. Cold stress was associated with risk in a few vulnerable subgroups. Awareness and mitigation strategies such as hydration, reducing outdoor activities, affordable heating and cooling systems, and climate change governance may be beneficial. Further studies with the UTCI are required.
Publisher: Springer Science and Business Media LLC
Date: 10-03-2023
DOI: 10.1007/S13224-021-01617-4
Abstract: Stillbirth is over-represented in lower and lower-middle-income countries and understandably this has motivated greater research investment in the development of prediction models. Prediction is particularly challenging for pregnancy outcomes because only part of the population is represented in observational research. Notably, unrecognised pregnancies and miscarriages are typically excluded from the development of prediction models and the consequences of such selection are not well understood. Other methodological challenges in developing stillbirth prediction models are within the control of the researcher. Identifying whether the intended model is for aetiological explanation versus prediction, attainment of a sufficiently large representative s le, and internal and external validation are among such methodological considerations. These considerations are discussed in relation to a recently published study on prediction of stillbirth after 28 weeks of pregnancy for women with hypertensive disorders of pregnancy in India. The predictive ability of this model amounts to the flip of a coin. Future screening based on such a model may be expensive, increase psychological distress among patients and introduce additional iatrogenic perinatal morbidities from over-treatment. Future research should address the methodological considerations described in this article.
Publisher: BMJ
Date: 2013
Publisher: Wiley
Date: 06-2022
Abstract: To investigate whether intervening miscarriages and induced abortions impact the associations between interpregnancy interval after a live birth and adverse pregnancy outcomes. Population‐based cohort study. Norway. A total of 165 617 births to 143 916 women between 2008 and 2016. We estimated adjusted relative risks for adverse pregnancy outcomes using log‐binomial regression, first ignoring miscarriages and induced abortions in the interpregnancy interval estimation ( conventional interpregnancy interval estimates ) and subsequently accounting for intervening miscarriages or induced abortions ( correct interpregnancy interval estimates ). We then calculated the ratio of the two relative risks (ratio of ratios, RoR) as a measure of the difference. The proportion of short interpregnancy interval ( months) was 4.0% in the conventional interpregnancy interval estimate and slightly increased to 4.6% in the correct interpregnancy interval estimate. For interpregnancy interval months, compared with 18–23 months, the RoR was 0.97 for preterm birth (PTB) (95% confidence interval [CI] 0.83–1.13), 0.97 for spontaneous PTB ( 95% CI 0.80–1.19), 1.00 for small‐for‐gestational age ( 95% CI 0.86–1.14), 1.00 for large‐for‐gestational age (95% CI 0.90–1.10) and 0.99 for pre‐ecl sia (95% CI 0.71–1.37). Similarly, conventional and correct interpregnancy intervals yielded associations of similar magnitude between long interpregnancy interval (≥60 months) and the pregnancy outcomes evaluated. Not considering intervening pregnancy loss due to miscarriages or induced abortions, results in negligible difference in the associations between short and long interpregnancy intervals and adverse pregnancy outcomes. Not considering pregnancy loss in interpregnancy interval estimation resulted no meaningful differences in observed risks of adverse pregnancy outcomes.
Publisher: Elsevier BV
Date: 11-2004
DOI: 10.1016/J.ATHEROSCLEROSIS.2004.07.007
Abstract: Lipoprotein retention on extracellular matrix (ECM) may play a central role in atherogenesis, and a specific extracellular matrix proteoglycan, biglycan, has been implicated in lipoprotein retention in human atherosclerosis. To test whether increased cellular biglycan expression results in increased retention of lipoproteins on ECM, rat aortic smooth muscle cells (SMCs) were transduced with a human biglycan cDNA-containing retroviral vector (LBSN) or with an empty retroviral vector (LXSN). To assess the importance of biglycan's glycosaminoglycan side chains in lipoprotein retention, ECM binding studies were also performed using RASMCs transduced with a retroviral vector encoding for a mutant, glycosaminoglycan-deficient biglycan (LBmutSN). Human biglycan mRNA and protein were confirmed in LBSN and LBmutSN RASMCs by Northern and Western blot analyses. HDL3+E binding to SMC ECM was increased significantly (as determined by 95% confidence intervals for binding curves) for LBSN as compared to either LXSN or LBmutSN cells the increases for LBSN cell ECM were due primarily to an approximately 50% increase in binding sites (increased Bmax) versus LXSN cell ECM and of approximately 25% versus LBmutSN cell ECM. These results are consistent with the hypothesis that biglycan, through its glycosaminoglycan side chains, may mediate lipoprotein retention on atherosclerotic plaque ECM.
Publisher: Springer Science and Business Media LLC
Date: 20-04-2012
Publisher: MDPI AG
Date: 21-11-2020
Abstract: Prenatal exposure to ambient air pollution and extreme temperatures are among the major risk factors of adverse birth outcomes and with potential long-term effects during the life course. Although low- and middle-income countries (LMICs) are most vulnerable, there is limited synthesis of evidence in such settings. This document describes a protocol for both an umbrella review (Systematic Review 1) and a focused systematic review and meta-analysis of studies from LMICs (Systematic Review 2). We will search from start date of each database to present, six major academic databases (PubMed, CINAHL, Scopus, MEDLINE/Ovid, EMBASE/Ovid and Web of Science Core Collection), systematic reviews repositories and references of eligible studies. Additional searches in grey literature will also be conducted. Eligibility criteria include studies of pregnant women exposed to ambient air pollutants and/or extreme temperatures during pregnancy with and without adverse birth outcomes. The umbrella review (Systematic Review 1) will include only previous systematic reviews while Systematic Review 2 will include quantitative observational studies in LMICs. Searches will be restricted to English language using comprehensive search terms to consecutively screen the titles, abstracts and full-texts to select eligible studies. Two independent authors will conduct the study screening and selection, risk of bias assessment and data extraction using JBI SUMARI web-based software. Narrative and semi-quantitative syntheses will be employed for the Systematic Review 1. For Systematic Review 2, we will perform meta-analysis with two alternative meta-analytical methods (quality effect and inverse variance heterogeneity) as well as the classic random effect model. If meta-analysis is infeasible, narrative synthesis will be presented. Confidence in cumulative evidence and the strength of the evidence will be assessed. This protocol is registered with PROSPERO (CRD42020200387).
Publisher: Wiley
Date: 03-10-2017
Abstract: Little is known about the risk of non-recurrent adverse birth outcomes. To evaluate the risk of stillbirth, preterm birth (PTB), and small for gestational age (SGA) as a proxy for fetal growth restriction (FGR) following exposure to one or more of these factors in a previous birth. We searched MEDLINE, EMBASE, Maternity and Infant Care, and Global Health from inception to 30 November 2016. Studies were included if they investigated the association between stillbirth, PTB, or SGA (as a proxy for FGR) in two subsequent births. Meta-analysis and pooled association presented as odds ratios (ORs) and adjusted odds ratios (aORs). Of the 3399 studies identified, 17 met the inclusion criteria. A PTB or SGA (as a proxy for FGR) infant increased the risk of subsequent stillbirth ((pooled OR 1.70 95% confidence interval, 95% CI, 1.34-2.16) and (pooled OR 1.98 95% CI 1.70-2.31), respectively). A combination of exposures, such as a preterm SGA (as a proxy for FGR) birth, doubled the risk of subsequent stillbirth (pooled OR 4.47 95% CI 2.58-7.76). The risk of stillbirth also varied with prematurity, increasing three-fold following PTB <34 weeks of gestation (pooled OR 2.98 95% CI 2.05-4.34) and six-fold following preterm SGA (as a proxy for FGR) <34 weeks of gestation (pooled OR 6.00 95% CI 3.43-10.49). A previous stillbirth increased the risk of PTB (pooled OR 2.82 95% CI 2.31-3.45), and subsequent SGA (as a proxy for FGR) (pooled OR 1.39 95% CI 1.10-1.76). The risk of stillbirth, PTB, or SGA (as a proxy for FGR) was moderately elevated in women who previously experienced a single exposure, but increased between two- and three-fold when two prior adverse outcomes were combined. Clinical guidelines should consider the inter-relationship of stillbirth, PTB, and SGA, and that each condition is an independent risk factor for the other conditions. Risk of adverse birth outcomes in next pregnancy increases with the combined number of previous adverse events. Why and how was the study carried out? Each year, around 2.6 million babies are stillborn, 15 million are born preterm (<37 weeks of gestation), and 32 million are born small for gestational age (less than tenth percentile for weight, smaller than usually expected for the relevant pregnancy stage). Being born preterm or small for gestational age can increase the chance of long-term health problems. The effect of having a stillbirth, preterm birth, or small-for-gestational-age infant in a previous pregnancy on future pregnancy health has not been summarised. We identified 3399 studies of outcomes of previous pregnancies, and 17 were summarised by our study. What were the main findings? The outcome of the previous pregnancy influenced the risk of poor outcomes in the next pregnancy. Babies born to mothers who had a previous preterm birth or small-for-gestational-age birth were more likely to be stillborn. The smaller and the more preterm the previous baby, the higher the risk of stillbirth in the following pregnancy. The risk of stillbirth in the following pregnancy was doubled if the previous baby was born both preterm and small for gestational age. Babies born to mothers who had a previous stillbirth were more likely to be preterm or small for gestational age. What are the limitations of the work? We included a small number of studies, as there are not enough studies in this area (adverse birth outcomes followed by adverse cross outcomes in the next pregnancy). We found very few studies that compared the risk of small for gestational age after preterm birth or stillbirth. Definitions of stillbirth, preterm birth categories, and small for gestational age differed across studies. We did not know the cause of stillbirth for most studies. What are the implications for patients? Women who have a history of poor pregnancy outcomes are at greater risk of poor outcomes in following pregnancies. Health providers should be aware of this risk when treating patients with a history of poor pregnancy outcomes.
Publisher: Wiley
Date: 15-06-2021
DOI: 10.1111/PPE.12774
Abstract: Short and long interpregnancy intervals (IPI) are associated with increased risk of hypertensive disorders of pregnancy, yet whether this association is modified by maternal age remains unclear. To examine if the association between IPI and hypertensive disorders of pregnancy varies by maternal age at birth prior to IPI. We conducted a population‐based cohort study of all mothers who had their first two (n = 169 896) consecutive births in Western Australia (WA) between 1980 and 2015. We estimated the risk of preecl sia and gestational hypertension for 6 to 60 months of IPI according to maternal age at birth prior to IPI ( years, 20‐24, 25‐29, 30‐34 and ≥35 years). We modelled IPI using restricted cubic splines and reported adjusted relative risk (RRs) with 95% CI at 6, 12, 24, 36, 48 and 60 months, with 18 months as reference. The risk of preecl sia was increased at longer IPIs (60 months) compared to 18 months for mothers 35 years or older (RR 2.19, 95% confidence interval (CI) 1.14, 4.18) and to a lesser extent for mothers 30‐ to 34 years old (RR 1.43, 95% CI 1.10, 1.84). Compared to 18 months, the risk of preecl sia was lower at 12 months of IPI for mothers younger than 20 years (RR 0.74, 95% CI 0.57, 0.96), but not for mothers 35 years or older (RR 0.62, 95% CI 0.36, 1.07). There was insufficient evidence for increased risk of hypertensive disorders of pregnancy at shorter IPIs of months for mothers of all ages. Our findings challenge the “one size fits all” recommendation for an optimal IPI, and a more tailored approach to family planning counselling may be required to improve health.
Publisher: Elsevier BV
Date: 07-2014
DOI: 10.1016/J.HEALTHPLACE.2014.05.004
Abstract: This study analysed spatial and temporal variation in childhood incidence of type 1 diabetes mellitus (T1DM) among Western Australia׳s 36 Health Districts from 1991 to 2010. There was a strong latitudinal gradient of 3.5% (95% CI, 0.2-7.2) increased risk of T1DM per degree south of the Equator, as averaged across the range 15-35° south. This pattern is consistent with the hypothesis of vitamin D deficiency at higher latitudes. In addition there was a 2.4% (95% CI, 1.3-3.6) average increase in T1DM incidence per year. These effects could not be explained by population density, socioeconomic status, remoteness or ethnicity.
Publisher: Elsevier BV
Date: 04-2019
Publisher: BMJ
Date: 31-03-2023
DOI: 10.1136/ARCHDISCHILD-2022-324269
Abstract: To assess the association between in utero exposure to seasonal inactivated influenza vaccine (IIV) and the risk of a diagnosis of a neurodevelopmental disorder in early childhood. Retrospective cohort study. Population-based birth registry linked with health administrative databases in Western Australia (WA). Singleton, liveborn children born between 1 April 2012 and 1 July 2016 in WA. Receipt of seasonal IIV during pregnancy obtained from a state-wide antenatal vaccination database. Clinical diagnosis of a neurodevelopmental disorder was recorded from hospital inpatient and emergency department records. We used Cox proportional hazard regression, weighted by the inverse-probability of treatment (vaccination), to estimate the hazard ratio (HR) of neurodevelopmental disorders associated with in utero exposure to seasonal IIV. The study included 140 514 children of whom, 15 663 (11.2%) were exposed to seasonal IIV in utero . The prevalence of neurodevelopmental disorders was 5.4%, including mental or behavioural (0.4%), neurological (5.1%), seizure (2.2%) and sleep disorders (2.7%). Maternal IIV was not associated with increased risk of neurodevelopmental disorders (HR 1.00 95% CI 0.91 to 1.08). Children exposed in the first trimester had a lower risk of seizure disorders (adjusted HR [aHR] 0.73 95% CI 0.54 to 0.998), and preterm children exposed any time during pregnancy had a lower risk of sleep disorders (aHR 0.63 95% CI 0.41 to 0.98). We did not observe increased risk of neurodevelopmental disorders following in utero exposure to seasonal IIV. Although we observed some evidence for lower risk of seizure and sleep disorders, additional studies are required to confirm.
Publisher: Wiley
Date: 16-06-2020
Publisher: Oxford University Press (OUP)
Date: 05-09-2019
DOI: 10.1093/AJE/KWY187
Publisher: Oxford University Press (OUP)
Date: 05-09-2019
DOI: 10.1093/AJE/KWY188
Publisher: BMJ
Date: 31-07-2012
DOI: 10.1136/OEMED-2011-100509
Abstract: Fetal growth restriction has been inconsistently associated with maternal exposure to elevated levels of traffic-related air pollution. We investigated the relationship between an in idualised measure of fetal growth and maternal exposure to a specific marker for traffic-related air pollution. We estimated maternal residential exposure to a marker for traffic-related air pollution (nitrogen dioxide, NO2) during pregnancy for 23,452 births using temporally adjusted land-use regression. Logistic regression was used to investigate associations with small for gestational age and sex (SGA) and fetal growth restriction, defined as proportion of optimal birth weight (POBW) below the 10th percentile. Sub-populations investigated were: women who spent most time at home, women who did not move house, women with respiratory or circulatory morbidity, women living in low/middle/high socio-economic areas, women who delivered before 37 weeks gestation, and women who delivered from 37 weeks gestation. An IQR increase in traffic-related air pollution in the second trimester across all women was associated with an OR of 1.31 (95% CI 1.07 to 1.60) for fetal growth restriction. Effects on fetal growth restriction (low POBW) were highest among women who subsequently delivered before 37 weeks of gestation. Effects on SGA were highest among women who did not move house: OR 1.35 (95% CI 1.08 to 1.69). Larger effect sizes were observed for low POBW than for SGA. Exposure to traffic-related air pollution in mid to late pregnancy was associated with risk of SGA and low POBW in this study.
Publisher: Wiley
Date: 28-03-2022
DOI: 10.1111/AJO.13505
Abstract: To evaluate maternal birth and neonatal outcomes among women with gestational diabetes mellitus (GDM), but without specific medical conditions and eligible for vaginal birth who underwent induction of labour (IOL) at term compared with those who were expectantly managed. Population‐based cohort study of women with GDM, but without medical conditions, who had a singleton, cephalic birth at 38–41 completed weeks gestation, in New South Wales, Australia between January 2010 and December 2016. Women who underwent IOL at 38, 39, 40 weeks gestation (38‐, 39‐, 40‐induction groups) were compared with those who were managed expectantly and gave birth at and/or beyond the respective gestational age group (38‐, 39‐, 40‐expectant groups). Multivariable logistic regression analysis was used to assess the association between IOL and adverse maternal birth and neonatal outcomes taking into account potential confounding by maternal age, country of birth, smoking, residential location, residential area of socioeconomic disadvantage and birth year. Of 676 762 women who gave birth during the study period, 66 606 (10%) had GDM of these, 34799 met the inclusion criteria. Compared with expectant management, those in 38‐ (adjusted odds ratio (aOR) 1.11 95% CI, 1.04–1.18), 39‐ (aOR 1.21 95% CI, 1.14–1.28) and 40‐ (aOR 1.50 95% CI, 1.40–1.60) induction groups had increased risk of caesarean section. Women in the 38‐induction group also had an increased risk of composite neonatal morbidity (aOR 1.10 95% CI, 1.01–1.21), which was not observed at 39‐ and 40‐induction groups. We found no difference between groups in perinatal death or neonatal intensive care unit admission for births at any gestational age. In women with GDM but without specific medical conditions and eligible for vaginal birth, IOL at 38, 39, 40 weeks gestation is associated with an increased risk of caesarean section.
Publisher: BMJ
Date: 09-08-2012
Abstract: Pre-ecl sia is a common complication of pregnancy and is a major cause of fetal-maternal mortality and morbidity. Despite a number of plausible mechanisms by which air pollutants might contribute to this process, few studies have investigated the association between pre-ecl sia and traffic emissions, a major contributor to air pollution in urban areas. The authors investigated the association between traffic-related air pollution and risk of pre-ecl sia in a maternal population in the urban centre of Perth, Western Australia. The authors estimated maternal residential exposure to a marker for traffic-related air pollution (nitrogen dioxide, NO(2)) during pregnancy for 23 452 births using temporally adjusted land-use regression. Logistic regression was used to investigate associations with pre-ecl sia. Each IQR increase in levels of traffic-related air pollution in whole pregnancy and third trimester was associated with a 12% (1%-25%) and 30% (7%-58%) increased risk of pre-ecl sia, respectively. The largest effect sizes were observed for women aged younger than 20 years or 40 years or older, aboriginal women and women with pre-existing and gestational diabetes, for whom an IQR increase in traffic-related air pollution in whole pregnancy was associated with a 34% (5%-72%), 35% (0%-82%) and 53% (7%-219%) increase in risk of pre-ecl sia, respectively. Elevated exposure to traffic-related air pollution in pregnancy was associated with increased risk of pre-ecl sia. Effect sizes were highest for elevated exposures in third trimester and among younger and older women, aboriginal women and women with diabetes.
Publisher: Springer Science and Business Media LLC
Date: 15-06-2012
Publisher: Environmental Health Perspectives
Date: 10-2014
DOI: 10.1289/EHP.1307741
Publisher: Informa UK Limited
Date: 24-01-2019
Publisher: S. Karger AG
Date: 2017
DOI: 10.1159/000479513
Abstract: Food allergy is a major clinical and public health concern worldwide. The risk factors are well defined, however, the mechanisms by which they affect immune development remain largely unknown, and unfortunately the effective treatment or prevention of food allergy is still being researched. Recent studies show that the genes that are critical for the development of food allergy are regulated through DNA methylation. Environmental factors can affect host DNA methylation status and subsequently predispose people to food allergy. DNA methylation is therefore an important mediator of gene-environment interactions in food allergy and key to understanding the mechanisms underlying the allergic development. Indeed, the modification and identification of the methylation levels of specific genetic loci have gained increasing attention for therapeutic and diagnostic application in combating food allergy. In this review, we summarize and discuss the recent developments of DNA methylation in food allergy, including the pathogenesis, therapy, and diagnosis. This review will also summarize and discuss the environmental factors that affect DNA methylation levels in food allergy.
Publisher: Elsevier BV
Date: 07-2022
Publisher: Wiley
Date: 25-06-2015
DOI: 10.1111/PPE.12202
Abstract: The caesarean delivery rate in the developed world has been increasing. It is not well understood how caesarean delivery rates have changed by gestational age at birth in Western Australia, particularly in relation to the introduction of the early-term delivery guidelines in Australia in 2006. Data from the Western Australian Midwives Notification System were used to identify 193,136 singletons born to primiparous women at 34-42 weeks' gestation during 1995-2010. Caesarean delivery rates were calculated by gestational age group (34-36 weeks, 37-38 weeks, and 39-42 weeks) and stratified into pre-labour and in-labour caesarean delivery. The average annual percent change (AAPC) for the caesarean delivery rates was calculated using joinpoint regression. Log-binomial regression was used to estimate the risk of having a caesarean delivery while adjusting for maternal and antenatal factors. Caesarean delivery rates rose steadily from 1995 to 2005 (AAPC = 5.9%, [95% confidence interval (CI) 4.9, 6.9]), but stabilised since then (AAPC = 0.9%, [95% CI -1.9, 3.8]). The rate of in-labour caesarean deliveries rose consistently from 1995 to 2010 across all gestational age groups. The pre-labour caesarean delivery rate rise was most dominant at 37-38 weeks' gestation from 1995 to 2005 (AAPC = 6.8%, [95% CI 5.4, 8.2]), but declined during 2006-10 (AAPC = -4.5, [95% CI -6.7, -2.3]), while at the same time the rate at 39-42 weeks rose slightly. The rise in pre-labour caesarean deliveries during 1995-2005 occurred predominantly at 37-38 weeks' gestation, but declined again from 2006 to 2010. This suggests that the recently developed Australian early-term delivery guidelines may have had some success in reducing early-term deliveries in Western Australia.
Publisher: Elsevier BV
Date: 12-2014
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.JPEDS.2017.07.051
Abstract: To quantify the independent risks of neonatal (0-28 days), postneonatal (29-364 days), 1- to 5- and 6- to 30-year mortality by gestational age and investigate changes in survival over time in an Australian birth cohort. Maternal and birth related Western Australian population data (1980-2010) were linked to the state mortality data using a retrospective cohort study design involving 722 399 live-born singletons infants. When compared with 39- to 41-week born infants, the adjusted risk ratio for neonatal mortality was 124.8 (95% CI 102.9-151.3) for 24-31 weeks of gestation, 3.4 (95% CI 2.4-4.7) for 35-36 weeks of gestation, and 1.4 (95% CI 1.1-1.8) for 37-38 weeks of gestation. For 24-31 weeks of gestation infants, the adjusted hazard ratio for postneonatal mortality (29-364 days) was 13.9 (95% CI 10.9-17.6), for 1- to 5-year mortality 1.4 (95% CI 0.7-3.0) and for 6- to 30-year mortality 1.3 (95% CI 0.8-2.3). The risk of neonatal and postneonatal mortality for those born preterm decreased over time. In Western Australia, late preterm and early term infants experienced higher risk of neonatal and postneonatal mortality when compared with their full-term peers. There was insufficient evidence to show that gestational length was independently associated with mortality beyond 1 year of age. Neonatal and postneonatal mortality improved with each decade of the study period.
Publisher: Springer Science and Business Media LLC
Date: 19-06-2013
Publisher: BMJ
Date: 29-06-2021
DOI: 10.1136/ARCHDISCHILD-2021-322210
Abstract: To assess whether clinical and/or laboratory-confirmed diagnosis of maternal influenza during pregnancy increases the risk of seizures in early childhood. Analysis of prospectively collected registry data for children born between 2009 and 2013 in three high-income countries. We used Cox regression to estimate country-level adjusted HRs (aHRs) fixed-effects meta-analyses were used to pool adjusted estimates. Population-based. 1 360 629 children born between 1 January 2009 and 31 December 2013 in Norway, Australia (New South Wales) and Canada (Ontario). Clinical and/or laboratory-confirmed diagnosis of maternal influenza infection during pregnancy. We extracted data on recorded seizure diagnosis in secondary/specialist healthcare between birth and up to 7 years of age additional analyses were performed for the specific seizure outcomes ‘epilepsy’ and ‘febrile seizures’. Among 1 360 629 children in the study population, 14 280 (1.0%) were exposed to maternal influenza in utero. Exposed children were at increased risk of seizures (aHR 1.17, 95% CI 1.07 to 1.28), and also febrile seizures (aHR 1.20, 95% CI 1.07 to 1.34). There was no strong evidence of an increased risk of epilepsy (aHR 1.07, 95% CI 0.81 to 1.41). Risk estimates for seizures were higher after influenza infection during the second and third trimester than for first trimester. In this large international study, prenatal exposure to influenza infection was associated with increased risk of childhood seizures.
Publisher: Springer Science and Business Media LLC
Date: 15-08-2013
Publisher: IEEE
Date: 04-2017
Publisher: BMJ
Date: 26-08-0003
DOI: 10.1136/ARCHDISCHILD-2015-308809
Abstract: To investigate hypospadias’ prevalence and trends, rate of surgical repairs and post-repair complications in an Australian population. Hypospadias cases were identified from all live-born infants in New South Wales, Australia, during the period 2001–2010, using routinely collected birth and hospital data. Prevalence, trends, surgical procedures or repairs, hospital admissions and complications following surgery were evaluated. Risk factors for reoperation and complications were assessed using multivariate logistic regression. There were 3186 boys with hypospadias in 2001–2010. Overall prevalence was 35.1 per 10 000 live births and remained constant during the study period. Proportions of anterior, middle, proximal and unspecified hypospadias were 41.3%, 26.2%, 5.8% and 26.6%, respectively. Surgical procedures were performed in 1945 boys (61%), with 1718 primary repairs. The overall post-surgery complication rate involving fistulas or strictures was 13%, but higher (33%) for proximal cases. Complications occurred after 1 year post-repair in 52.3% of cases and up to 5 years. Boys with proximal or middle hypospadias were at increased risk of reoperation or complications, but age at primary repair did not affect the outcome. One in 285 infants were affected with hypospadias, 60% required surgical repair or correction and one in eight experienced complications. The frequency of late complications would suggest that clinical review should be maintained for year post-repair.
Publisher: Springer Science and Business Media LLC
Date: 27-02-2023
DOI: 10.1038/S41562-023-01522-Y
Abstract: Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from −90% to +30%, were reported in many countries following early COVID-19 pandemic response measures (‘lockdowns’). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data from 52 million births in 26 countries, 18 of which had representative population-based data, with overall PTB rates ranging from 6% to 12% and stillbirth ranging from 2.5 to 10.5 per 1,000 births. We show small reductions in PTB in the first (odds ratio 0.96, 95% confidence interval 0.95–0.98, P value .0001), second (0.96, 0.92–0.99, 0.03) and third (0.97, 0.94–1.00, 0.09) months of lockdown, but not in the fourth month of lockdown (0.99, 0.96–1.01, 0.34), although there were some between-country differences after the first month. For high-income countries in this study, we did not observe an association between lockdown and stillbirths in the second (1.00, 0.88–1.14, 0.98), third (0.99, 0.88–1.12, 0.89) and fourth (1.01, 0.87–1.18, 0.86) months of lockdown, although we have imprecise estimates due to stillbirths being a relatively rare event. We did, however, find evidence of increased risk of stillbirth in the first month of lockdown in high-income countries (1.14, 1.02–1.29, 0.02) and, in Brazil, we found evidence for an association between lockdown and stillbirth in the second (1.09, 1.03–1.15, 0.002), third (1.10, 1.03–1.17, 0.003) and fourth (1.12, 1.05–1.19, .001) months of lockdown. With an estimated 14.8 million PTB annually worldwide, the modest reductions observed during early pandemic lockdowns translate into large numbers of PTB averted globally and warrant further research into causal pathways.
Publisher: Wiley
Date: 15-03-2023
DOI: 10.1111/PPE.12969
Publisher: Springer Science and Business Media LLC
Date: 02-2013
DOI: 10.1007/S00464-012-2774-6
Abstract: The risks of adverse obstetric outcomes among young women survivors of colorectal cancer (CRC) are uncertain. This Western Australian, whole-jurisdictional linked-data, retrospective cohort study compared maternal and neonatal outcomes of first postcancer pregnancies among women CRC survivors against randomly selected pregnancies of women with no cancer history. Logistic regression models were used to investigate a range of adverse outcomes independently associated with CRC and its surgical and adjunctive treatments. Among 627,762 deliveries during the study period (1983-2007), 232 were first pregnancies following CRC. Whether following laparoscopic or open cancer surgery, these pregnancies were independently associated with a significantly increased risk of antepartum hemorrhage [odds ratios (ORs): 1.25 2.13 for the respective procedures], postpartum hemorrhage (ORs: 1.61 3.31), Cesarean delivery (ORs: 2.42 4.24), infant low Apgar score (ORs: 1.32 2.64), need for neonatal resuscitation (ORs: 1.49 3.20), and special care admission (ORs: 1.42 2.87). A history of open (but not laparoscopic) cancer surgery was associated with increased risk of gastrointestinal obstruction during pregnancy (OR 1.17) and prolonged postpartum hospitalization (OR 3.11). Neither was significantly associated with perinatal death. Among women with previous CRC, rectal (versus colonic) malignancy was independently associated with a significantly higher risk of overall maternal and neonatal adverse outcomes (ORs: 3.73 and 2.73, respectively), as was radiotherapy (ORs: 4.24 and 2.81, respectively). Chemotherapy was independently associated with a marginally but significantly higher risk of overall maternal but not neonatal outcomes (ORs: 1.11 0.98). Open versus laparoscopic cancer surgery was associated with a significantly higher risk of antepartum and postpartum hemorrhage, low Apgar score, need for neonatal resuscitation, and neonatal special care admission. Previous CRCs, particularly rectal and radiation-treated tumors, appear to confer an increased likelihood of adverse outcomes in subsequent pregnancies. Laparoscopic technique for CRC surgery may reduce adverse gestational outcomes.
Publisher: Elsevier BV
Date: 02-2017
Publisher: BMJ
Date: 10-2020
DOI: 10.1136/BMJOPEN-2020-038846
Abstract: To investigate the prevalence of, and associations between, prenatal and perinatal risk factors and developmental vulnerability in twins at age 5. Retrospective cohort study using bivariate and multivariable logistic regression. Western Australia (WA), 2002–2015. 828 twin pairs born in WA with an Australian Early Development Census (AEDC) record from 2009, 2012 or 2015. The AEDC is a national measure of child development across five domains. Children with scores th percentile were classified as developmentally vulnerable on, one or more domains (DV1), or two or more domains (DV2). In this population, 26.0% twins were classified as DV1 and 13.5% as DV2. In the multivariable model, risk factors for DV1 were maternal age years (adjusted OR (aOR): 7.06, 95% CI: 2.29 to 21.76), child speaking a language other than English at home (aOR: 6.45, 95% CI: 2.17 to 19.17), male child (aOR: 5.08, 95% CI: 2.89 to 8.92), age younger than the reference category for the study s le (≥5 years 1 month to years 10 months) at time of AEDC completion (aOR: 3.34, 95% CI: 1.55 to 7.22) and having a proportion of optimal birth weight (POBW) th percentile of the study s le (aOR: 2.06, 95% CI 1.07 to 3.98). Risk factors for DV2 were male child (aOR: 7.87, 95% CI: 3.45 to 17.97), maternal age (aOR: 5.60, 95% CI: 1.30 to 24.10), age younger than the reference category (aOR: 5.36, 95% CI: 1.94 to 14.82), child speaking a language other than English at home (aOR: 4.65, 95% CI: 1.14 to 19.03), mother’s marital status as not married at the time of twins’ birth (aOR: 4.59, 95% CI: 1.13 to 18.55), maternal occupation status in the lowest quintile (aOR: 3.30, 95% CI: 1.11 to 9.81) and a POBW th percentile (aOR: 3.11, 95% CI: 1.26 to 7.64). Both biological and sociodemographic risk factors are associated with developmental vulnerability in twins at 5 years of age.
Publisher: MDPI AG
Date: 07-07-2022
Abstract: (1) Background: Miscarriages occur in approximately 15–25% of all pregnancies. There is limited evidence suggesting an association between history of miscarriage and the development of diabetic and hypertensive disorders in women. This systematic review aims to collate the existing literature and provide up to date epidemiological evidence on the topic. (2) Methods: We will search CINAHL Plus, Ovid/EMBASE, Ovid/MEDLINE, ProQuest, PubMed, Scopus, Web of Science, and Google Scholar, using a combination of medical subject headings, keywords, and search terms, for relevant articles related to the association between miscarriage and the risk of diabetic and hypertensive disorders. Cross-sectional, case–control, nested case–control, case–cohort, and cohort studies published from inception to April 2022 will be included in the search strategy. Three reviewers will independently screen studies and the risk of bias will be assessed using the Joanna Briggs Institute Critical Appraisal tool. Where the data permit, a meta-analysis will be conducted. (3) Results: The results of this systematic review will be submitted to a peer-reviewed journal for publication. (4) Conclusions: The findings of this systematic review will instigate efforts to manage and prevent reproductive, cardiovascular, and metabolic health consequences associated with miscarriages.
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.ENVRES.2017.07.044
Abstract: Estimating exposure to particulate matter (PM
Publisher: Springer Science and Business Media LLC
Date: 25-11-2017
Publisher: Springer Science and Business Media LLC
Date: 2012
Publisher: MDPI AG
Date: 31-12-2020
Abstract: Ambient fine particulate matter .5 µm (PM2.5) air pollution increases premature mortality globally. Some PM2.5 is natural, but anthropogenic PM2.5 is comparatively avoidable. We determined the impact of long-term exposures to the anthropogenic PM component on mortality in Australia. PM2.5-attributable deaths were calculated for all Australian Statistical Area 2 (SA2 n = 2310) regions. All-cause death rates from Australian mortality and population databases were combined with annual anthropogenic PM2.5 exposures for the years 2006–2016. Relative risk estimates were derived from the literature. Population-weighted average PM2.5 concentrations were estimated in each SA2 using a satellite and land use regression model for Australia. PM2.5-attributable mortality was calculated using a health-impact assessment methodology with life tables and all-cause death rates. The changes in life expectancy (LE) from birth, years of life lost (YLL), and economic cost of lost life years were calculated using the 2019 value of a statistical life. Nationally, long-term population-weighted average total and anthropogenic PM2.5 concentrations were 6.5 µg/m3 (min 1.2–max 14.2) and 3.2 µg/m3 (min 0–max 9.5), respectively. Annually, anthropogenic PM2.5-pollution is associated with 2616 (95% confidence intervals 1712, 3455) deaths, corresponding to a 0.2-year (95% CI 0.14, 0.28) reduction in LE for children aged 0–4 years, 38,962 (95%CI 25,391, 51,669) YLL and an average annual economic burden of $6.2 billion (95%CI $4.0 billion, $8.1 billion). We conclude that the anthropogenic PM2.5-related costs of mortality in Australia are higher than community standards should allow, and reductions in emissions are recommended to achieve avoidable mortality.
Publisher: Springer Science and Business Media LLC
Date: 03-2021
Publisher: SAGE Publications
Date: 26-05-2015
Abstract: The neighborhood influences on walking are well recognized, yet less is known about how the environment impacts sedentary behaviors. This study used a social-ecological model to examine the correlates of sitting time, independent of walking behavior. Objective built environment measures and self-reported community participation were examined for associations with sitting time for 1,179 residents in Perth, Western Australia. Neighborhood built environment and social factors were significantly associated with women’s sitting time only. In particular, the presence of community infrastructure was negatively associated with women’s weekday sitting (relative reduction = 0.951 p = .037), but statistical significance weakened after accounting for community participation (relative reduction = 0.951 p = .057). Community participation was independently associated with both women’s weekday and weekend sitting (both p .001). More walkable neighborhoods may help limit women’s sitting time by providing better access to community infrastructure, as local venues may afford additional opportunities for social interaction and participation.
Publisher: Oxford University Press (OUP)
Date: 06-2023
DOI: 10.1093/IJE/DYAD072
Abstract: Aboriginal and Torres Strait Islander (hereafter Aboriginal) women have a high prevalence of diabetes in pregnancy (DIP), which includes pre-gestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM). We aimed to characterize the impact of DIP in babies born to Aboriginal mothers. A retrospective cohort study, using routinely collected linked health data that included all singleton births (N = 510 761) in Western Australia between 1998 and 2015. Stratified by Aboriginal status, generalized linear mixed models quantified the impact of DIP on neonatal outcomes, estimating relative risks (RRs) with 95% CIs. Ratio of RRs (RRRs) examined whether RRs differed between Aboriginal and non-Aboriginal populations. Exposure to DIP increased the risk of adverse outcomes to a greater extent in Aboriginal babies. PGDM heightened the risk of large for gestational age (LGA) (RR: 4.10, 95% CI: 3.56–4.72 RRR: 1.25, 95% CI: 1.09–1.43), macrosomia (RR: 2.03, 95% CI: 1.67–2.48 RRR: 1.39, 95% CI: 1.14–1.69), shoulder dystocia (RR: 4.51, 95% CI: 3.14–6.49 RRR: 2.19, 95% CI: 1.44–3.33) and major congenital anomalies (RR: 2.14, 95% CI: 1.68–2.74 RRR: 1.62, 95% CI: 1.24–2.10). GDM increased the risk of LGA (RR: 2.63, 95% CI: 2.36–2.94 RRR: 2.00, 95% CI: 1.80–2.22), macrosomia (RR: 1.95, 95% CI: 1.72–2.21 RRR: 2.27, 95% CI: 2.01–2.56) and shoulder dystocia (RR: 2.78, 95% CI: 2.12–3.63 RRR: 2.11, 95% CI: 1.61–2.77). Birthweight mediated about half of the DIP effect on shoulder dystocia only in the Aboriginal babies. DIP differentially increased the risks of fetal overgrowth, shoulder dystocia and congenital anomalies in Aboriginal babies. Improving care for Aboriginal women with diabetes and further research on preventing shoulder dystocia among these women can reduce the disparities.
Publisher: Public Library of Science (PLoS)
Date: 07-12-2022
DOI: 10.1371/JOURNAL.PGPH.0001008
Abstract: Every year, around 20 million women worldwide give birth to low birth weight (LBW) infants, with majority of these births occurring in low-and middle-income countries, including the Solomon Islands. Few studies have explored the pregnancy lived experience of women who deliver LBW infants. The aim of the study is to understand the lived experience of women in the Solomon Islands who gave birth to LBW infants by exploring their personal (socio-demographic and health), behavioural, social and environmental contexts. We used a qualitative descriptive approach and purposely selected 18 postnatal women with LBW infants in the Solomon Islands for an in-depth interview. All data were analysed using thematic analysis in NVivo. We identified six themes reported as being related to LBW: health issues, diet and nutrition, substance use, domestic violence, environmental conditions and antenatal care. Our findings suggest that women in the Solomon Islands are exposed to various personal, behavioural, social and environmental risk factors during pregnancy that can impact birth outcomes, particularly LBW. We recommend further research should be redirected to look at the factors/themes identified in the interviews.
Publisher: Wiley
Date: 18-11-2022
DOI: 10.1111/PPE.12835
Publisher: Springer Science and Business Media LLC
Date: 06-03-2018
DOI: 10.1038/S41370-018-0026-0
Abstract: Health studies on spatially-varying exposures (e.g., air pollution) during pregnancy often estimate exposure using residence at birth, disregarding residential mobility. We investigated moving patterns in pregnant women (n = 10,116) in linked cohorts focused on Connecticut and Massachusetts, U.S., 1988-2008. Moving patterns were assessed by race/ethnicity, age, marital status, education, working status, population density, parity, income, and season of birth. In this population, 11.6% of women moved during pregnancy. Movers were more likely to be younger, unmarried, and living in urban areas with no previous children. Among movers, multiple moves were more likely for racial/ethnic minority, younger, less educated, unmarried, and lower income women. Most moves occurred later in pregnancy, with 87.4% of first moves in the second or third trimester, although not all cohort subjects enrolled in the first few weeks of pregnancy. Distance between first and second residence had a median value of 5.2 km (interquartile range 11.3 km, average 57.8 km, range 0.0-4277 km). Women moving larger distances were more likely to be white, older, married, and work during pregnancy. Findings indicate that residential mobility may impact studies of spatially-varying exposure during pregnancy and health and that subpopulations vary in probability of moving, and timing and distance of moves.
Publisher: Wiley
Date: 05-11-2021
DOI: 10.1111/PPE.12715
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2014
Publisher: Oxford University Press (OUP)
Date: 23-07-2021
DOI: 10.1093/NTR/NTAB135
Abstract: The benefit of smoking cessation in reducing the risk of preterm birth is well established. Relatively less well understood is the prevalence of smoking cessation maintenance at the next pregnancy and the associated preterm risk reduction. The aim of this study was to estimate the prevalence of maintenance of smoking cessation at second pregnancy and the associated relative risk of preterm birth. This was a longitudinal study with retrospectively obtained records of births to multiparous women who smoked in the pregnancy of their first birth in New South Wales, 1994–2016 (N = 63 195 mothers). Relative risks (RR) of preterm birth of the second child were estimated for smoking cessation with adjustment for final gestational age of the first birth, maternal age at the first birth, change in socioeconomic disadvantage between the first and second pregnancy, interpregnancy interval, and calendar time. Approximately 34% (N = 21 540) of women who smoked during their first pregnancy did not smoke in the second pregnancy. Smoking cessation among women who smoked at first pregnancy was associated with a 26% (95% CI: 21%, 31%) decrease in risk of preterm birth at a second pregnancy. Despite smoking during the first pregnancy, smoking cessation was achieved and maintained by more than one-third of women in their second pregnancy with encouraging levels of preterm risk reduction. It is well-established that the period after birth provides an opportunity to reduce smoking-related morbidity for both the mother and neonate. Our results indicate that this period also offers an opportunity to prevent morbidity of future pregnancy. A considerable amount of research has been undertaken on the effects of smoking during pregnancy on birth outcomes, the influence of postpartum smoking on the health of the mother and newborn child, and postpartum smoking cessation. However, follow-up of women after giving birth does not tend to be long enough to observe smoking and outcomes of subsequent pregnancies. We show that smoking cessation in the subsequent pregnancy is achievable by a large proportion of women despite smoking in their first pregnancy, which translates to clear reductions in risk of preterm birth in the subsequent pregnancy.
Publisher: Public Library of Science (PLoS)
Date: 05-04-2022
DOI: 10.1371/JOURNAL.PMED.1003963
Abstract: Few studies have evaluated the effect of maternal influenza vaccination on the development of allergic and autoimmune diseases in children beyond 6 months of age. We aimed to investigate the association between in utero exposure to seasonal inactivated influenza vaccine (IIV) and subsequent diagnosis of allergic and autoimmune diseases. This longitudinal, population-based linked cohort study included 124,760 singleton, live-born children from 106,206 mothers in Western Australia (WA) born between April 2012 and July 2016, with up to 5 years of follow-up from birth. In our study cohort, 64,169 (51.4%) were male, 6,566 (5.3%) were Aboriginal and/or Torres Strait Islander children, and the mean age at the end of follow-up was 3.0 (standard deviation, 1.3) years. The exposure was receipt of seasonal IIV during pregnancy. The outcomes were diagnosis of an allergic or autoimmune disease, including asthma and anaphylaxis, identified from hospital and/or emergency department (ED) records. Inverse probability of treatment weights (IPTWs) accounted for baseline probability of vaccination by maternal age, Aboriginal and/or Torres Strait Islander status, socioeconomic status, body mass index, parity, medical conditions, pregnancy complications, prenatal smoking, and prenatal care. The models additionally adjusted for the Aboriginal and/or Torres Strait Islander status of the child. There were 14,396 (11.5%) maternally vaccinated children 913 (6.3%) maternally vaccinated and 7,655 (6.9%) maternally unvaccinated children had a diagnosis of allergic or autoimmune disease, respectively. Overall, maternal influenza vaccination was not associated with diagnosis of an allergic or autoimmune disease (adjusted hazard ratio [aHR], 1.02 95% confidence interval [CI], 0.95 to 1.09). In trimester-specific analyses, we identified a negative association between third trimester influenza vaccination and the diagnosis of asthma ( n = 40 aHR, 0.70 95% CI, 0.50 to 0.97) and anaphylaxis ( n = 36 aHR, 0.67 95% CI, 0.47 to 0.95).We did not capture outcomes diagnosed in a primary care setting therefore, our findings are only generalizable to more severe events requiring hospitalization or presentation to the ED. Due to small cell sizes (i.e., ), estimates could not be determined for all outcomes after stratification. In this study, we observed no association between in utero exposure to influenza vaccine and diagnosis of allergic or autoimmune diseases. Although we identified a negative association of asthma and anaphylaxis diagnosis when seasonal IIV was administered later in pregnancy, additional studies are needed to confirm this. Overall, our findings support the safety of seasonal inactivated influenza vaccine during pregnancy in relation to allergic and autoimmune diseases in early childhood and support the continuation of current global maternal vaccine programs and policies.
Publisher: Public Library of Science (PLoS)
Date: 06-02-2013
Publisher: Elsevier BV
Date: 10-2018
Publisher: Public Library of Science (PLoS)
Date: 2013
Publisher: Oxford University Press (OUP)
Date: 19-10-2017
DOI: 10.1093/AJE/KWX335
Publisher: SAGE Publications
Date: 07-08-2019
Abstract: The evidence associating diet and risk of multiple sclerosis is inconclusive. We investigated associations between dietary patterns and risk of a first clinical diagnosis of central nervous system demyelination, a common precursor to multiple sclerosis. We used data from the 2003–2006 Ausimmune Study, a case–control study examining environmental risk factors for a first clinical diagnosis of central nervous system demyelination, with participants matched on age, sex and study region. Using data from a food frequency questionnaire, dietary patterns were identified using principal component analysis. Conditional logistic regression models ( n = 698, 252 cases, 446 controls) were adjusted for history of infectious mononucleosis, serum 25-hydroxyvitamin D concentrations, smoking, race, education, body mass index and dietary misreporting. We identified two major dietary patterns – healthy (high in poultry, fish, eggs, vegetables, legumes) and Western (high in meat, full-fat dairy low in wholegrains, nuts, fresh fruit, low-fat dairy), explaining 9.3% and 7.5% of variability in diet, respectively. A one-standard deviation increase in the healthy pattern score was associated with a 25% reduced risk of a first clinical diagnosis of central nervous system demyelination (adjusted odds ratio 0.75 95% confidence interval 0.60, 0.94 p = 0.011). There was no statistically significant association between the Western dietary pattern and risk of a first clinical diagnosis of central nervous system demyelination. Following healthy eating guidelines may be beneficial for those at high risk of multiple sclerosis.
Publisher: Wiley
Date: 03-03-2019
Abstract: To describe the characteristics and outcomes of older adult (≥65 years) major trauma patients in comparison with younger adults (16-64 years). To determine whether older age is associated with a reduced likelihood of transport (directly or indirectly) to a major trauma centre and whether this is associated with in-hospital mortality. A retrospective cohort study of major trauma patients transported to hospital by St John Ambulance paramedics in Perth, Western Australia, between 1 January 2013 and 31 December 2016. Multivariate logistic regression was used to test the relationship between age and major trauma centre transport. Multivariate logistic regression analysis using inverse probability of treatment weighting was used to determine if major trauma centre transport was associated with in-hospital mortality in older adults. One thousand six hundred and twenty-five patients were included of these 576 (35%) were ≥65 years. In comparison with younger adults, older adults had more falls as their mechanism of injury (n = 358 [62%] versus n = 102 [10%], P ≤ 0.001) and more major head injuries (n = 472 [82%] versus n = 609 [58%], P ≤ 0.001). Older adults had lower odds (adjusted odds ratio 0.52, 95% confidence interval [CI] 0.35-0.78) of major trauma centre transport and this was associated with 1.7 times the likelihood of in-hospital mortality (95% CI 1.04-2.7). Older adults who were not transported to the trauma centre had an increased odds of in-hospital mortality. However, older age was associated with a significantly reduced likelihood of trauma centre transport. With the aging population, the development of specific prehospital triage criteria to enable the complexities of this higher-risk population to be identified is important.
Publisher: BMJ
Date: 03-2021
DOI: 10.1136/BMJOPEN-2020-045319
Abstract: To investigate the associations between interpregnancy intervals (IPIs) and developmental vulnerability in children’s first year of full-time school (age 5). Retrospective cohort study using logistic regression. ORs were estimated for associations with IPIs with adjustment for child, parent and community sociodemographic variables. Western Australia (WA), 2002–2015. 34 574 WA born singletons with a 2009, 2012 or 2015 Australian Early Development Census (AEDC) record. The AEDC measures child development across five domains Physical Health and Wellbeing, Social Competence, Emotional Maturity, Language and Cognitive Skills (school-based) and Communication Skills and General Knowledge. Children with scores th percentile were classified as developmentally vulnerable on, one or more domains (DV1), or two or more domains (DV2). 22.8% and 11.5% of children were classified as DV1 and DV2, respectively. In the adjusted models (relative to the reference category, IPIs of 18–23 months), IPIs of months were associated with an increased risk of children being classified as DV1 (adjusted OR (aOR) 1.17, 95% CI 1.08 to 1.34), DV2 (aOR 1.31, 95% CI 1.10 to 1.54) and an increased risk of developmental vulnerability for the domains of Physical Health and Wellbeing (aOR 1.25, 95% CI 1.06 to 1.48) and Emotional Maturity (aOR 1.36, 95% CI 1.12 to 1.66). All IPIs longer than the reference category were associated with and increased risk of children being classified as DV1 and DV2 (aOR .15). IPIs of 60–119 months and ≥120 months, were associated with an increased risk of developmental vulnerability on each of the five AEDC domains, with greater odds for each domain for the longer IPI category. IPIs showed independent J-shaped relationships with developmental vulnerability, with short ( months) and longer (≥24 months) associated with increased risks of developmental vulnerability.
Publisher: Informa UK Limited
Date: 21-09-2017
DOI: 10.1080/15459624.2017.1335402
Abstract: Nickel is a widely-used material in many industries. Although there is enough evidence that occupational exposure to nickel may cause respiratory illnesses, allergies, and even cancer, it is not possible to stop the use of nickel in occupational settings. Nickel exposure, however, can be controlled and reduced significantly in workplaces. The main objective of this study was to assess if educational intervention of hygiene behavior could reduce nickel exposure among Indonesian nickel smelter workers. Participants were randomly assigned to three intervention groups (n = 99). Group one (n = 35) received only an educational booklet about nickel, related potential health effects and preventive measures, group two (n = 35) attended a presentation in addition to the booklet, and group three (n = 29) received personal feedback on their biomarker results in addition to the booklet and presentations. Pre- and post-intervention air s ling was conducted to measure concentrations of dust and nickel in air along with worker's blood and urine nickel concentrations. The study did not measure significant differences in particles and nickel concentrations in the air between pre- and post-interventions. However, we achieved significant reductions in the post intervention urine and blood nickel concentrations which can be attributed to changes in personal hygiene behavior. The median urinary nickel concentration in the pre-intervention period for group one was 52.3 µg/L, for group two 57.4 µg/L, and group three 43.2 µg/L which were significantly higher (p< = 0.010) than those measured in the post-intervention period for each of the groups with 8.5 µg/L, 9.6 µg/L, and 8.2 µg/L, respectively. A similar pattern was recorded for serum nickel with significantly (p < 0.05) higher median concentrations measured in the pre-intervention period for group one 1.7 µg/L, and 2.0 µg/L for group 2 and group 3 compared with the post intervention median serum nickel levels of 0.1 µg/L for all groups. The study showed that educational interventions can significantly reduce personal exposure levels to nickel among Indonesian nickel smelter workers.
Publisher: Wiley
Date: 14-08-2023
Abstract: To assess the usefulness of night‐time presentations to measure alcohol‐related harm (ARH) in young trauma patients, aged 12–24 years, attending Western Australian EDs. A retrospective longitudinal study examined alcohol‐related ED presentations in Western Australia (WA 2002–2016) among 12‐ to 24‐year‐olds. Data from the Emergency Department Data Collection, WA State Trauma Registry Database and Hospital Morbidity Data Collection were used to identify ARH through specific codes and text searches. These were compared to ARH estimates based on presentation time. Statistical analysis involved sensitivity and specificity calculations and Cox proportional hazards modelling. We identified 2644 (17.8%) night‐time presentations as a proxy measure of ARH among the 14 887 presentations of patients aged 12–24 years. This closely matched the 3064 (20.6%) identified as ARH through coding methods. The highest risk for an ARH presentation occurred during the night hours between 00.00 and 04.59 hours. During these hours, the risk was 4.4–5.1 times higher compared to presentations at midday (between 12.00 and 12.59 hours). However, when looking at in idual patients, we observed that night‐time presentations were not a strong predictor of ARH (sensitivity: 0.39 positive predictive value: 0.46). Implementing targeted interventions during night hours could be beneficial in addressing ARH presentations. However, relying solely on the time of presentation as a proxy for ARH is unlikely to effectively identify ARH in young in iduals. Instead, the present study emphasises the importance of implementing mandatory data collection strategies in EDs to ensure accurate measurement of ARH cases.
Publisher: BMJ
Date: 23-07-2014
DOI: 10.1136/BMJ.G4333
Publisher: SAGE Publications
Date: 03-2023
DOI: 10.1177/10105395231158868
Abstract: Low birth weight (LBW) has contributed to more than 80% of under-5 deaths worldwide, most occurring in low- and middle-income countries. We used the 2015 Solomon Islands Demographic and Health Survey data to identify the prevalence and risks associated with LBW in the Solomon Islands. Low birth weight prevalence estimated was 10%. After adjustment for potential confounders, we found the risk of LBW for women with a history of marijuana and kava use was 2.6 times, adjusted relative risk (aRR) 2.64 and 2.5 times (aRR: 2.50) than among unexposed women, respectively. Polygamous relationship, no antenatal care, decision-making by another person were 84% (aRR: 1.84), 73% (aRR: 1.73), and 73% (aRR: 1.73) than among unexposed women, respectively. We also found that 10% and 4% of LBW cases in the Solomon Islands were attributable to a household of more than five members and tobacco and cigarette use history respectively. We concluded that LBW in the Solomon Islands relied more on behavioral risk factors, including substance use as well as health and social risk factors. We recommended further study on kava use and its impact on pregnancy and LBW.
Publisher: MDPI AG
Date: 11-02-2022
Abstract: Fine particulate matter air pollution (PM2.5) is a potential cause of preterm birth. Inconsistent findings from observational studies have motivated researchers to conduct more studies, but some degree of study heterogeneity is inevitable. The consequence of this feedback is a burgeoning research effort that results in marginal gains. The aim of this study was to develop and apply a method to establish the sufficiency and stability of estimates of associations as they have been published over time. Cohort studies identified in a recent systematic review and meta-analysis on the association between preterm birth and whole-pregnancy exposure to PM2.5 were selected. The estimates of the cohort studies were pooled with cumulative meta-analysis, whereby a new meta-analysis was run for each new study published over time. The relative risks (RR) and 95% confidence interval (CI) limits needed for a new study to move the cumulative RR to 1.00 were calculated. Findings indicate that the cumulative relative risks (cRR) for PM2.5 (cRR 1.07, 95% CI 1.03, 1.12) converged in 2015 (RR 1.07, 95% CI 1.01, 1.14). To change conclusions to a null association, a new study would need to observe a protective RR of 0.93 (95% CI limit 1.02) with precision equivalent to that achieved by all past 24 cohort studies combined. Preterm birth is associated with elevated PM2.5, and it is highly unlikely that any new observational study will alter this conclusion. Consequently, establishing whether an observational association exists is now less relevant an objective for future studies than characterising risk (magnitude, impact, pathways, populations and potential bias) and interventions. Sufficiency and stability can be effectively applied in meta-analyses and have the potential to reduce research waste.
Publisher: Public Library of Science (PLoS)
Date: 16-01-2013
Publisher: Springer Science and Business Media LLC
Date: 2009
Publisher: Wiley
Date: 13-06-2023
DOI: 10.1111/AJO.13548
Abstract: Antenatal inactivated influenza (IIV) and pertussis‐containing vaccines (dTpa) offer protection against severe respiratory infections for pregnant women and infants months of age. Both vaccines are recommended in pregnancy however, little is known about temporal or jurisdictional trends and predictors of uptake. To identify gaps and predictors of IIV and/or dTpa vaccinations in Australian pregnancies from 2012 to 2017. We conducted a probabilistically linked, multi‐jurisdictional population‐based cohort study, drawing from perinatal data collections and immunisation databases. We used a generalised linear mixed model with a random effect term to account for clustering of multiple pregnancies within mothers, to calculate vaccination uptake, and identify predictors of uptake by maternal demographic, pregnancy, and health characteristics. Of 591 868 unique pregnancies, IIV uptake was 15%, dTpa 27% and 12% received both vaccines. Pertussis vaccinations in First Nations pregnancies were 20% lower than non‐Indigenous pregnancies dTpa was strongly associated with IIV uptake (risk ratio (RR): 8.60, 95% CI 8.48–8.73). This trend was temporally and jurisdictionally consistent. First Nations women were more likely to have had IIV in pregnancy before the introduction of dTpa in the pregnancy program: (RR: 1.48, 95% CI 1.40–1.57), but less likely after dTpa implementation (RR: 0.78, 95% CI 0.76–0.80). Inequity in vaccine uptake between First Nations and non‐Indigenous pregnancies, and dismal rates of vaccination in pregnancy overall need urgent review, particularly before the next influenza pandemic or pertussis outbreak. If antenatal dTpa is driving IIV uptake, changes in antenatal healthcare practices are needed to ensure vaccines are offered equitably and optimally to protect against infection.
Publisher: MDPI AG
Date: 24-07-2019
Abstract: Indigenous children have much higher rates of ear and lung disease than non-Indigenous children, which may be related to exposure to high levels of geogenic (earth-derived) particulate matter (PM). The aim of this study was to assess the relationship between dust levels and health in Indigenous children in Western Australia (W.A.). Data were from a population-based s le of 1077 Indigenous children living in 66 remote communities of W.A. ( ,000,000 km2), with information on health outcomes derived from carer reports and hospitalisation records. Associations between dust levels and health outcomes were assessed by multivariate logistic regression in a multi-level framework. We assessed the effect of exposure to community s led PM on epithelial cell (NuLi-1) responses to non-typeable Haemophilus influenzae (NTHi) in vitro. High dust levels were associated with increased odds of hospitalisation for upper (OR 1.77 95% CI [1.02–3.06]) and lower (OR 1.99 95% CI [1.08–3.68]) respiratory tract infections and ear disease (OR 3.06 95% CI [1.20–7.80]). Exposure to PM enhanced NTHi adhesion and invasion of epithelial cells and impaired IL-8 production. Exposure to geogenic PM may be contributing to the poor respiratory health of disadvantaged communities in arid environments where geogenic PM levels are high.
Publisher: American Chemical Society (ACS)
Date: 04-11-2016
Abstract: Including satellite observations of nitrogen dioxide (NO
Publisher: Public Library of Science (PLoS)
Date: 08-12-2014
Publisher: Springer Science and Business Media LLC
Date: 02-06-2011
Publisher: Informa UK Limited
Date: 22-02-2021
DOI: 10.1080/14767058.2021.1874339
Abstract: Infants born preterm at <37 + 0 weeks of gestation experience systemic complications later in adulthood. However, the risk of adults born preterm delivering preterm babies themselves is not well investigated. Midwives Notifications of births for the Western Australian population from 1980 to 2010 were obtained. A retrospective cohort study of 958,729 live-born singletons infants was conducted. Logistic regression was used to estimate odds ratios of preterm birth for preterm born parents compared to term born parents. Adjustment was made for socioeconomic status (quintiles of an area level disadvantage score), parity, maternal age, and ethnicity. A total of 876,755 term and 81,974 preterm babies were born during the study period. Information on the preterm birth status of the mother or father was available for 138,123 children. Of these, 1555 (12.08%) children were born preterm to parents born preterm (either of the two parents were preterm), 11,504 (9.22%) preterm children were born to parents born at term, 11,319 term children were born to parents born preterm and 113,254 term children were born to parents born at term. 68,915 (8.39%) preterm children were born where parents' whose gestational age was unknown. The unadjusted and adjusted odds ratios with and 95% confidence intervals (CI) for the odds of preterm born adults delivering preterm child were 1.35 (1.29-1.42, In Western Australia delivering a preterm child is 25% greater when the parent was born preterm than when the parent was born at term in Western Australia. The effect appears to be transgenerational.
Publisher: Elsevier BV
Date: 11-2021
Publisher: Elsevier BV
Date: 04-2018
Start Date: 2010
End Date: 2010
Funder: Australia-China Council
View Funded ActivityStart Date: 2013
End Date: 2016
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2013
End Date: 2016
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2016
End Date: 2019
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2013
End Date: 2016
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2013
End Date: 2017
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2009
End Date: 2010
Funder: The University of Western Australia
View Funded ActivityStart Date: 2009
End Date: 2011
Funder: Healthway
View Funded ActivityStart Date: 2018
End Date: 2021
Funder: National Health and Medical Research Council
View Funded Activity