ORCID Profile
0000-0002-9885-8261
Current Organisations
University of New South Wales
,
The University of Newcastle
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Biomedical and clinical sciences | Crop and pasture production | Paediatrics | Heritage, archive and museum studies | Criminology | Cardiovascular medicine and haematology | Information systems | Biological sciences | Agricultural, veterinary and food sciences | Human society | History, heritage and archaeology | Information and computing sciences | Plant biology | Immunology
ANZSRC Socio-Economic Objective (SEO)
There are no SEO codes available for Bronwyn Brew
Related Links
Publications
A sociological autopsy lens on older adult suicide in rural Australia: Addressing health, psychosocial factors and care practices at the intersection of policies and institutions
Publisher: Elsevier BV
Date: 09-2021
Genetic Architectures of Childhood- and Adult-Onset Asthma Are Partly Distinct
Publisher: Elsevier BV
Date: 04-2019
TGF-beta 1 dissociates human proximal tubule cell growth and Na(+)-H+ exchange activity
Publisher: Elsevier BV
Date: 06-1998
Comorbidity of adult asthma and gastroesophageal reflux disease in a large twin cohort: the role of genes and affective traits
Publisher: European Respiratory Society
Date: 05-09-2021
The health and wellbeing of Australian farmers: A longitudinal cohort study
Publisher: Springer Science and Business Media LLC
Date: 15-09-2016
Asthma and subsequent school performance at age 15–16 years: A Swedish population-based sibling control study
Publisher: Springer Science and Business Media LLC
Date: 06-05-2020
DOI: 10.1038/S41598-020-64633-W
Abstract: Asthma may negatively affect children’s school performance, such as grades and exam results. Results from previous studies have shown varying results and may have suffered from confounding and other biases. We used a Swedish population-based cohort of 570,595 children with data on asthma (including severity and control) in Grades 7–8 and 9, school performance from Grade 9 (grade point sum, non-eligibility for upper secondary school and national test results) and measured confounders from national registers. We used sibling comparisons to account for unmeasured familial factors. Children with asthma and severe asthma performed slightly better in school than children without asthma when adjusting for measured confounders, but the associations were attenuated in sibling comparisons. In contrast, children with uncontrolled asthma performed slightly worse (e.g. Grade 9: β adj = −9.9 95% CI −12.8 to −7.0 Cohen’s d = 0.16). This association remained for uncontrolled asthma in Grade 9 in sibling comparisons (Grade 9: β = −7.7 points 95% CI −12.6 to −2.6 Cohen’s d = 0.12), but not for Grades 7–8. The attenuation of estimates when controlling for familial factors using sibling comparisons suggests that the differences were due to familial factors, rather than being causal. The remaining associations in sibling comparisons between uncontrolled asthma in Grade 9 and school performance are consistent with a causal association.
Perinatal factors and respiratory health in children
Publisher: Wiley
Date: 29-10-2012
Farm Safety Practices and Farm Size in New South Wales
Publisher: Informa UK Limited
Date: 16-06-2017
The familial aggregation of atopic diseases and depression or anxiety in children
Publisher: Wiley
Date: 04-2018
DOI: 10.1111/CEA.13127
Towards non-conventional methods of designing register-based epidemiological studies: An application to pediatric research
Publisher: SAGE Publications
Date: 07-2017
Abstract: Various epidemiological designs have been applied to investigate the causes and consequences of fetal growth restriction in register-based observational studies. This review seeks to provide an overview of several conventional designs, including cohort, case-control and more recently applied non-conventional designs such as family-based designs. We also discuss some practical points regarding the application and interpretation of family-based designs. Definitions of each design, the study population, the exposure and the outcome measures are briefly summarised. Ex les of study designs are taken from the field of low birth-weight research for illustrative purposes. Also examined are relative advantages and disadvantages of each design in terms of assumptions, potential selection and information bias, confounding and generalisability. Kinship data linkage, statistical models and result interpretation are discussed specific to family-based designs. When all information is retrieved from registers, there is no evident preference of the case-control design over the cohort design to estimate odds ratios. All conventional designs included in the review are prone to bias, particularly due to residual confounding. Family-based designs are able to reduce such bias and strengthen causal inference. In the field of low birth-weight research, family-based designs have been able to confirm a negative association not confounded by genetic or shared environmental factors between low birth weight and the risk of asthma. We conclude that there is a broader need for family-based design in observational research as evidenced by the meaningful contributions to the understanding of the potential causal association between low birth weight and subsequent outcomes.
Early-life antibiotic use and risk of asthma and eczema: results of a discordant twin study
Publisher: European Respiratory Society (ERS)
Date: 05-03-2020
DOI: 10.1183/13993003.02021-2019
Abstract: Early-life antibiotic use has been associated with the development of atopic diseases, but the aetiology remains unclear. To elucidate the aetiology, we used a discordant twin design to control for genetic and environmental confounding. We conducted a retrospective cohort study in twins aged 3–10 years from the Netherlands Twin Register (NTR, n=35 365) and a replication study in twins aged 9 years from the Childhood and Adolescent Twin Study in Sweden (CATSS, n=7916). Antibiotic use was recorded at age 0–2 years. Doctor-diagnosed asthma and eczema were reported by parents when children were aged 3–12 years in both cohorts. In iduals were included in unmatched analyses and in co-twin control analyses with disease discordant twin pairs. Early-life antibiotic use was associated with increased risk of asthma (NTR OR 1.34, 95% CI 1.28–1.41 CATSS OR 1.45, 95% CI 1.34–1.56) and eczema (NTR OR 1.08, 95% CI 1.03–1.13 CATSS OR 1.07, 95% CI 1.01–1.14) in unmatched analyses. Co-twin analyses in monozygotic and dizygotic twin pairs showed similar results for asthma (NTR OR 1.54, 95% CI 1.20–1.98 CATSS OR 2.00, 95% CI 1.28–3.13), but opposing results for eczema in the NTR (OR 0.99, 95% CI 0.80–1.25) and the CATSS (OR 1.67, 95% CI 1.12–2.49). The risk of asthma increased for antibiotics prescribed for respiratory infections (CATSS OR 1.45, 95% CI 1.34–1.56), but not for antibiotics commonly used for urinary tract/skin infections (CATSS OR 1.02, 95% CI 0.88–1.17). Children exposed to early-life antibiotic use, particularly prescribed for respiratory infections, may be at higher risk of asthma. This risk can still be observed when correcting for genetic and environmental factors. Our results could not elucidate whether the relationship between early-life antibiotic use and eczema is confounded by familial and genetic factors.
Performance of Six Birth-Weight and Estimated-Fetal-Weight Standards for Predicting Adverse Perinatal Outcome: A 10-Year Nationwide Population-Based Study
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2022
Acid Suppressant Use in Pregnancy and Asthma in Offspring: Should We Be Worried?
Publisher: American Academy of Pediatrics (AAP)
Date: 02-2018
Academic achievement of adolescents with asthma or atopic disease
Publisher: Wiley
Date: 06-03-2019
DOI: 10.1111/CEA.13371
Prescribed analgesics in pregnancy and the risk of child asthma- a register-based study.
Publisher: European Respiratory Society
Date: 15-09-2018
Asthma and affective traits in adults: a genetically informative study
Publisher: European Respiratory Society
Date: 28-09-2019
Prenatal maternal psychosocial stress and offspring's asthma and allergic disease: A systematic review and meta‐analysis
Publisher: Wiley
Date: 08-02-2018
DOI: 10.1111/CEA.13091
Abstract: Prenatal maternal stress may influence offspring's atopic risk through sustained cortisol secretion resulting from activation of the hypothalamic-pituitary axis (HPA), leading to Th2-biased cell differentiation in the foetus. We undertook a systematic review and meta-analysis investigating the relationship between prenatal maternal psychosocial stress and risk of asthma and allergy in the offspring. We searched 11 electronic databases from 1960 to 2016, searched the grey literature and contacted experts in the field. Type of stress indicator included mood disorders, anxiety, exposure to violence, bereavement and socio-economic problems occurring during pregnancy, both objectively and subjectively measured. We included all possible asthma and IgE-mediated allergy outcomes. We conducted random-effects meta-analyses to synthesize the data. We identified 9779 papers of which 30 studies (enrolling >6 million participants) satisfied inclusion criteria. The quality of 25 studies was moderate, 4 were strong, and one was weak. Maternal exposure to any type of stressors was associated with an increased risk of offspring atopic eczema/dermatitis (OR 1.34, 95% CI 1.22-1.47), allergic rhinitis (OR 1.30, 95% CI 1.04-1.62), wheeze (OR 1.34, 95% CI 1.16-1.54) and asthma (OR 1.15, 95% CI 1.04-1.27). Exposure to anxiety and depression had strongest effect compared to other stressors. Exposure during the third trimester had the greatest impact compared to first and second trimesters. The increased risk was stronger for early-onset and persistent than for late-onset wheeze. Bereavement of a child (HR 1.28, 95% CI 1.10-1.48) or a spouse (HR 1.40, 95% CI 1.03-1.90) increased the risk of offspring asthma. Exposure to prenatal maternal psychosocial stress was associated with increased risk, albeit modestly, of asthma and allergy in the offspring. The pronounced risk during the third trimester may represent cumulative stress exposure throughout pregnancy rather than trimester-specific effect. Our findings may represent a causal effect or a result of inherent biases in studies, particularly residual confounding.
Maternal anxiety, depression and asthma and adverse pregnancy outcomes – a population based study
Publisher: Springer Science and Business Media LLC
Date: 11-09-2019
DOI: 10.1038/S41598-019-49508-Z
Abstract: To evaluate associations between maternal anxiety or depression and adverse pregnancy outcomes, taking possible familial confounding and interaction with asthma into account, we conducted a cohort study of all singleton births in Sweden 2001–2013. We retrieved information about pregnancy, diagnoses of anxiety/depression, asthma, and prescribed medication from the Swedish Medical Birth, National Patient, and Prescribed Drug Registers. We estimated associations with regression models, performed cousin and sibling comparisons, and calculated interactions. In 950 301 identified pregnancies 5.9% had anxiety/depression and 4.0% had asthma. Anxiety/depression was associated with adverse pregnancy outcomes (e.g. preecl sia, adjusted Odds Ratio 1.17 (95% Confidence Interval 1.12, 1.22), instrumental delivery (1.14 (1.10, 1.18)), elective (1.62 (1.57, 1.68)) and emergency (1.32 (1.28, 1.35)) caesarean section (CS)). Their children had lower birth weight (−54 g (−59, −49)) and shorter gestational age (−0.29 weeks (−0.31, −0.28)). Associations were not confounded by familial factors and asthma did not modify the effect of anxiety/depression for outcomes other than elective CS, p 0.001. In women with anxiety/depression diagnosis, untreated women had higher odds of elective CS compared to women on medication (1.30 (1.17, 1.43)). In conclusion, anxiety/depression should be considered when evaluating pregnant women’s risk of complications such as preecl sia and non-vaginal deliveries.
Asthma and all-cause mortality in children and young adults: a population-based study
Publisher: BMJ
Date: 22-09-2020
DOI: 10.1136/THORAXJNL-2020-214655
Abstract: Studies suggest an increased all-cause mortality among adults with asthma. We aimed to study the relationship between asthma in children and young adults and all-cause mortality, and investigate differences in mortality rate by also having a life-limiting condition (LLC) or by parental socioeconomic status (SES). Included in this register-based study are 2 775 430 in iduals born in Sweden between January 1986 and December 2012. We identified asthma cases using the National Patient Register (NPR) and the Prescribed Drug Register. Those with LLC were identified using the NPR. Parental SES at birth (income and education) was retrieved from Statistics Sweden. We estimated the association between asthma and all-cause mortality using a Cox proportional hazards regression model. Effect modification by LLC or parental SES was studied using interaction terms in the adjusted model. The adjusted hazard rate (adjHR) for all-cause mortality in asthma cases versus non-asthma cases was 1.46 (95% CI 1.33 to 1.62). The highest increased rate appeared to be for those aged 5–15 years. In persons with asthma and without LLC, the adjHR remained increased at 1.33 (95% CI 1.18 to 1.50), but differed (p=0.002) from those with asthma and LLC, with an adjHR of 1.87 (95% CI 1.57 to 2.22). Parental SES did not alter the association (income, p=0.55 education, p=0.83). This study shows that asthma is associated with an increased mortality in children and young adults regardless of LLC or parental SES. Further research is warranted to investigate the possible mechanisms for this association.
Does a public online IVF prediction tool help set patient expectations? A mixed methods evaluation study
Publisher: Oxford University Press (OUP)
Date: 04-07-2023
Abstract: Does a public online IVF success prediction calculator based on real-world data help set patient expectations? The YourIVFSuccess Estimator aided consumer expectations of IVF success: one quarter (24%) of participants were unsure of their estimated IVF success before using the tool one half changed their prediction of success after using the tool and one quarter (26%) had their expectations of IVF success confirmed. Several web-based IVF prediction tools exist worldwide but have not been evaluated for their impact on patient expectations, nor for patient perceptions of usefulness and trustworthiness. This is a pre–post evaluation of a convenience s le of 780 online users of the Australian YourIVFSuccess Estimatoryourivfsuccess.com.au/ between 1 July and 31 November 2021. Participants were eligible if they were over 18 years of age, Australian residents, and considering IVF for themselves or their partner. Participants filled in online surveys before and after using the YourIVFSuccess Estimator. The response rate of participants who completed both surveys and the YourIVFSuccess Estimator was 56% (n = 439). The YourIVFSuccess Estimator aided consumer expectations of IVF success: one quarter (24%) of participants were unsure of their estimated IVF success before using the tool one half changed their prediction of success after using the tool (20% increased, 30% decreased), bringing their predictions in line with the YourIVFSuccess Estimator, and one quarter (26%) had their IVF success expectations confirmed. One in five participants claimed they would change the timing of IVF treatment. The majority of participants found the tool to be at least moderately trustworthy (91%), applicable (82%), and helpful (80%), and would recommend it to others (60%). The main reasons given for the positive responses were that the tool is independent (government funded, academic) and based on real-world data. Those who did not find it applicable or helpful were more likely to have had a worse-than-expected prediction, or to have experienced non-medical infertility (e.g. single women, LGBTQIA+), noting that at the time of evaluation the Estimator did not accommodate these patient groups. Those who dropped out between the pre- and post-surveys tended to have a lower education status or have been born outside of Australia or New Zealand, therefore there may be issues with generalizability. With consumers demanding increasing levels of transparency and participation in decisions around their medical care, public-facing IVF predictor tools based on real-world data are useful for aligning expectations about IVF success rates. Given differences in patient characteristics and IVF practices internationally, national data sources should be used to inform country-specific IVF prediction tools. The YourIVFSuccess website and evaluation of the YourIVFSuccess Estimator are supported by the Medical Research Future Fund (MRFF) Emerging Priorities and Consumer Driven Research initiative: EPCD000007. BKB, ND, and OF have no conflicts to declare. DM holds a clinical role at Virtus Health. His role did not influence the analysis plan or interpretation of results in this study. GMC is an employee of the UNSW Sydney, and Director of the UNSW NPESU. UNSW receives research funding on behalf of Prof Chambers from the MRFF to develop and manage the Your IVF Success website. Grant ID: MRFF Emerging Priorities and Consumer Driven Research initiative: EPCD000007. N/A.
Performance of six birth‐weight and estimated‐fetal‐weight standards for predicting adverse perinatal outcome: a 10‐year nationwide population‐based study
Publisher: Wiley
Date: 08-2021
DOI: 10.1002/UOG.22151
Abstract: To evaluate three birth‐weight (BW) standards (Australian population‐based, Fenton and INTERGROWTH‐21 st ) and three estimated‐fetal‐weight (EFW) standards (Hadlock, INTERGROWTH‐21 st and WHO) for classifying small‐for‐gestational age (SGA) and large‐for‐gestational age (LGA) and predicting adverse perinatal outcomes in preterm and term babies. This was a nationwide population‐based study conducted on a total of 2.4 million singleton births that occurred from 24 + 0 to 40 + 6 weeks' gestation between 2004 and 2013 in Australia. The performance of the growth charts was evaluated according to SGA and LGA classification, and relative risk (RR) and diagnostic accuracy based on the areas under the receiver‐operating‐characteristics curves (AUCs) for stillbirth, neonatal death, perinatal death, composite morbidity and a composite of perinatal death and morbidity outcomes. The analysis was stratified according to gestational age at delivery ( 37 + 0 vs ≥ 37 + 0 weeks). Following exclusions, 2 392 782 singleton births were analyzed. There were significant differences in the SGA and LGA classification and risk of adverse outcomes between the six BW and EFW standards evaluated. For the term group, compared with the other standards, the INTERGROWTH‐21 st BW and EFW standards classified half the number of SGA ( 10 th centile) babies (3–4% vs 7–11%) and twice the number of LGA ( 90 th centile) babies (24–25% vs 8–15%), resulting in a smaller cohort of term SGA at higher risk of adverse outcome and a larger LGA cohort at lower risk of adverse outcome. For term SGA ( 3 rd centile) babies, the RR of perinatal death using the two INTERGROWTH‐21 st standards was up to 1.5‐fold higher than those of the other standards (including the WHO‐EFW and Hadlock‐EFW), while the INTERGROWTH‐21 st ‐EFW standard indicated a 12–26% reduced risk of perinatal death for LGA cases across centile thresholds. Conversely, for the preterm group, the WHO‐EFW and Hadlock‐EFW standards identified a higher SGA classification rate than did the other standards (18–19% vs 10–11%) and a 20–65% increased risk of perinatal death in term LGA babies. All BW and EFW charts had similarly poor performance in predicting adverse outcomes, including the composite outcome (AUC range, 0.49–0.62) for both preterm (AUC range, 0.58–0.62) and term (AUC range, 0.49–0.50) cases and across centiles. Furthermore, specific centile thresholds for identifying adverse outcomes varied markedly by chart between BW and EFW standards. This study addresses the recurrent problem of identifying fetuses at risk of morbidity and perinatal mortality associated with growth disorders and provides new insights into the applicability of international growth standards. Our findings of marked variation in classification and the similarly poor performance of prescriptive international standards and the other commonly used standards raise questions about whether the prescriptive international standards that were constructed for universal adoption are indeed applicable to a multiethnic population such as that of Australia. Thus, caution is needed when adopting universal standards for clinical and epidemiological use. © 2020 International Society of Ultrasound in Obstetrics and Gynecology
Paediatric asthma and non‐allergic comorbidities: A review of current risk and proposed mechanisms
Publisher: Wiley
Date: 28-07-2022
DOI: 10.1111/CEA.14207
Abstract: It is increasingly recognized that children with asthma are at a higher risk of other non‐allergic concurrent diseases than the non‐asthma population. A plethora of recent research has reported on these comorbidities and progress has been made in understanding the mechanisms for comorbidity. The goal of this review was to assess the most recent evidence (2016–2021) on the extent of common comorbidities (obesity, depression and anxiety, neurodevelopmental disorders, sleep disorders and autoimmune diseases) and the latest mechanistic research, highlighting knowledge gaps requiring further investigation. We found that the majority of recent studies from around the world demonstrate that children with asthma are at an increased risk of having at least one of the studied comorbidities. A range of potential mechanisms were identified including common early life risk factors, common genetic factors, causal relationships, asthma medication and embryologic origins. Studies varied in their selection of population, asthma definition and outcome definitions. Next, steps in future studies should include using objective measures of asthma, such as lung function and immunological data, as well as investigating asthma phenotypes and endotypes. Larger complex genetic analyses are needed, including genome‐wide association studies, gene expression–functional as well as pathway analyses or Mendelian randomization techniques and identification of gene–environment interactions, such as epi‐genetic studies or twin analyses, including omics and early life exposure data. Importantly, research should have relevance to clinical and public health translation including clinical practice, asthma management guidelines and intervention studies aimed at reducing comorbidities.
541A Nationwide Evaluation of International Standards and Commonly-used Growth Charts for Predicting Adverse Perinatal Outcomes
Publisher: Oxford University Press (OUP)
Date: 09-2021
Abstract: Abnormal fetal growth is a risk factor for perinatal mortality and morbidity. There is considerable debate about the choice and performance of growth charts to classify newborns as small or large for gestational age (SGA and LGA) as a proxy for the at-risk infants. Several international charts have been proposed to be adopted worldwide. We aim to evaluate the performance of commonly-used growth charts (including international INTERGROWTH-21st-standards) for predicting adverse outcomes among SGA and LGA babies. A population cohort of 2.4 million singleton births (24+0–40+6 weeks) delivered in Australia, 2004–2013. Performance was evaluated by prevalence, relative risk and diagnostic accuracy for adverse outcome based on AUC. There was wide variation in SGA and LGA classification across charts. For ex le, compared to other charts, the INTERGROWTH-21st-standards classified half of the number of term-SGA babies (prevalence: 3-4% vs. 7-10%) (& th-centile) and double the number of LGA babies (prevalence: 24-25% vs. 8-18%) (& th-centile), resulting in a smaller cohort of term-SGA at higher-risk of adverse outcome, and a larger LGA cohort with lower-risk of adverse outcome. All charts performed poorly for detecting adverse outcomes (AUC range for a composite outcome: 0.49-0.68) and across birthweight centiles. Significant differences in the classification of newborns and the chart performance raises concerns about whether the INTERGROWTH-21st-standards are applicable to a multi-ethnic population such as Australia. Significant differences in the classification of newborns and the relatively poor predictive ability of growth charts means that over reliance on infant size alone may misclassify, and thus miss at-risk infants.
Using fathers as a negative control exposure to test the Developmental Origins of Health and Disease Hypothesis: A case study on maternal distress and offspring asthma using Swedish register data
Publisher: SAGE Publications
Date: 07-2017
Abstract: Developmental Origins of Health and Disease Hypothesis (DOHaD) studies are often observational in nature and are therefore prone to biases from loss to follow-up and unmeasured confounding. Register-based studies can reduce these issues since they allow almost complete follow-up and provide information on fathers that can be used in a negative control analysis to assess the impact of unmeasured confounding. The aim of this study was to propose a causal model for testing DOHaD using paternal exposure as a negative control, and its application to maternal distress in pregnancy and offspring asthma. A causal diagram including shared and parent-specific measured and unmeasured confounders for maternal (fetal) and paternal exposures is proposed. The case study consisted of all children born in Sweden from July 2006 to December 2008 ( n=254,150). Information about childhood asthma, parental distress and covariates was obtained from the Swedish national health registers. Associations between maternal and paternal distress during pregnancy and offspring asthma at age five years were assessed separately and with mutual adjustment for the other parent’s distress measure, as well as for shared confounders. Maternal distress during pregnancy was associated with offspring asthma risk mutually adjusted odds ratio (OR) (OR 1.32, 95% CI 1.23, 1.43). The mutually adjusted paternal distress−offspring asthma analysis (OR 1.05, 95% CI 0.97, 1.13) indicated no evidence for unmeasured confounding shared by the mother and father. Using paternal exposure in a negative control model to test the robustness of fetal programming hypotheses can be a relatively simple extension of conventional observational studies but limitations need to be considered.
1254Comorbidity of atopic diseases and gastroesophageal reflux in adults: a co-twin control study
Publisher: Oxford University Press (OUP)
Date: 09-2021
Abstract: Gastroesophageal reflux disease (GERD) is the most common non-allergic comorbidity in adults with asthma, however comorbidity with other atopic diseases such as eczema and hayfever is unclear. The objective was to assess the comorbidity of GERD with atopic diseases in adults, and to investigate possible mechanisms including genetic and affective factors. A co-twin control study harnessing 46 583 adult Swedish twins. Questionnaires on health status were linked to national patient and prescribed drug register data. Within twin-pair comparisons were made between unpaired, monozygotic (MZ) and dizygotic (DZ) twins to assess common genetic liability. Affective traits (depression, anxiety and neuroticism) were added to models to assess their role in comorbidity. The risk of GERD in those with asthma was OR1.52 (95% CI 1.38, 1.68) hayfever OR1.22 (95%CI 1.12, 1.34) and eczema OR1.23 (95%CI 1.10, 1.38). Within twin-pair associations attenuated in decreasing order of shared genetics for all atopic diseases e.g. self-report asthma with GERD: DZ twins adjOR1.41 (95%CI 0.96, 2.08), MZ twins adjOR1.24 (95%CI 0.82, 1.87). Adjusting for affective traits only slightly attenuated the comorbidity associations. GERD is a common comorbidity in adults with asthma, hayfever and/or eczema. We found evidence for shared genetic factors but not for affective traits. GERD is a common comorbidity not only in adults with asthma, but also in adults with eczema or hayfever. Twin research has revealed evidence for a common genetic liability to explain comorbidity.
Maternal asthma in Australian indigenous women and perinatal outcomes: A whole population–linked study
Publisher: Wiley
Date: 08-08-2023
DOI: 10.1002/IJGO.14363
Abstract: To assess the association between maternal asthma and adverse perinatal outcomes in an Australian Indigenous population. This prospective cohort study included all Indigenous mother and baby dyads for births from 2001 to 2013 in Western Australia ( n = 25 484). Data were linked from Western Australia Births, Deaths, Midwives, Hospital, and Emergency Department collections. Maternal asthma was defined as a self‐reported diagnosis at an antenatal visit or hospitalization or emergency visit for asthma during pregnancy or less than 3 years before pregnancy. Associations with birth, labor, and pregnancy outcomes were assessed using generalized estimating equations. Asthma exacerbation during pregnancy and stratification by remoteness was also assessed. Maternal asthma was associated with placental abruption (adjusted odds ratio [aOR], 1.59 [95% confidence interval (CI), 1.07–2.35]), threatened preterm labor (aOR, 1.58 [95% CI, 1.39–1.79]), and emergency cesarean sections (aOR, 1.27 [95% CI, 1.13–1.44]). These risks increased further with an asthma exacerbation during pregnancy or if the mother was from a remote area. No associations were found for low birth weight, preterm birth, small for gestational age, or perinatal mortality. Maternal asthma in Indigenous women is associated with an increased risk of emergency cesarean sections, placental abruption, and threatened preterm labor. These risks may be mitigated by improved management of asthma exacerbations during pregnancy.
Omega-3 supplementation during the first 5 years of life and later academic performance: a randomised controlled trial
Publisher: Springer Science and Business Media LLC
Date: 13-08-2015
Factors associated with personal hopefulness in older rural and urban residents of New South Wales
Publisher: Informa UK Limited
Date: 02-01-2015
Cohort profile
Publisher: Oxford University Press (OUP)
Date: 25-05-2018
DOI: 10.1093/IJE/DYY078
Academic achievement of adolescents with asthma and atopic diseases
Publisher: Morressier
Date: 17-05-2018
Identifying preventable risk factors for hospitalised asthma in young Aboriginal children: a whole-population cohort study
Publisher: BMJ
Date: 08-01-2021
DOI: 10.1136/THORAXJNL-2020-216189
Abstract: Australia has one of the highest rates of asthma worldwide. Indigenous children have a particularly high burden of risk determinants for asthma, yet little is known about the asthma risk profile in this population. To identify and quantify potentially preventable risk factors for hospitalised asthma in Australian Aboriginal children (1–4 years of age). Birth, hospital and emergency data for all Aboriginal children born 2003–2012 in Western Australia were linked (n=32 333). Asthma was identified from hospitalisation codes. ORs and population attributable fractions were calculated for maternal age at birth, remoteness, area-level disadvantage, prematurity, low birth weight, maternal smoking in pregnancy, mode of delivery, maternal trauma and hospitalisations for acute respiratory tract infection (ARTI) in the first year of life. There were 705 (2.7%) children hospitalised at least once for asthma. Risk factors associated with asthma included: being hospitalised for an ARTI (OR 4.06, 95% CI 3.44 to 4.78), area-level disadvantage (OR 1.58, 95% CI 1.28 to 1.94), being born at weeks’ gestation (OR 3.30, 95% CI 2.52 to 4.32) or birth weight g (OR 2.35, 95% CI 1.39 to 3.99). The proportion of asthma attributable to an ARTI was 31%, area-level disadvantage 18%, maternal smoking 5%, and low gestational age and birth weight were 3%–7%. We did not observe a higher risk of asthma in those children who were from remote areas. Improving care for pregnant Aboriginal women as well as for Aboriginal infants with ARTI may help reduce the burden of asthma in the Indigenous population.
The international Perinatal Outcomes in the Pandemic (iPOP) study: protocol
Publisher: F1000 Research Ltd
Date: 02-02-2021
DOI: 10.12688/WELLCOMEOPENRES.16507.1
Abstract: Preterm birth is the leading cause of infant death worldwide, but the causes of preterm birth are largely unknown. During the early COVID-19 lockdowns, dramatic reductions in preterm birth were reported however, these trends may be offset by increases in stillbirth rates. It is important to study these trends globally as the pandemic continues, and to understand the underlying cause(s). Lockdowns have dramatically impacted maternal workload, access to healthcare, hygiene practices, and air pollution - all of which could impact perinatal outcomes and might affect pregnant women differently in different regions of the world. In the international Perinatal Outcomes in the Pandemic (iPOP) Study, we will seize the unique opportunity offered by the COVID-19 pandemic to answer urgent questions about perinatal health. In the first two study phases, we will use population-based aggregate data and standardized outcome definitions to: 1) Determine rates of preterm birth, low birth weight, and stillbirth and describe changes during lockdowns and assess if these changes are consistent globally, or differ by region and income setting, 2) Determine if the magnitude of changes in adverse perinatal outcomes during lockdown are modified by regional differences in COVID-19 infection rates, lockdown stringency, adherence to lockdown measures, air quality, or other social and economic markers, obtained from publicly available datasets. We will undertake an interrupted time series analysis covering births from January 2015 through July 2020. The iPOP Study will involve at least 121 researchers in 37 countries, including obstetricians, neonatologists, epidemiologists, public health researchers, environmental scientists, and policymakers. We will leverage the most disruptive and widespread “natural experiment” of our lifetime to make rapid discoveries about preterm birth. Whether the COVID-19 pandemic is worsening or unexpectedly improving perinatal outcomes, our research will provide critical new information to shape prenatal care strategies throughout (and well beyond) the pandemic.
Effect of maternal asthma exacerbations on perinatal outcomes: a population-based study
Publisher: European Respiratory Society (ERS)
Date: 10-2020
DOI: 10.1183/23120541.00295-2020
Abstract: Although there is a growing body of literature about the impact of asthma exacerbations during pregnancy on adverse perinatal outcomes, it is still unclear whether asthma exacerbations themselves or asthma severity are the driving factor for negative outcomes. This study aimed to estimate the associations between maternal asthma exacerbations and perinatal outcomes, and whether this differed by asthma treatment regime as a proxy for severity. We included births of women with asthma in Sweden from July 2006 to November 2013 (n=33 829). Asthma exacerbations were defined as unplanned emergency visits/hospitalisations or a short course of oral corticosteroids. Adjusted odds ratios (aOR) were estimated for the associations between exacerbations during pregnancy and perinatal outcomes (small for gestational age (SGA), preterm birth, birthweight and mode of delivery), stratified by preconception treatment regime. Exacerbations occurred in 1430 (4.2%) pregnancies. Exacerbations were associated with reduced birthweight (aOR 1.45, 95% CI 1.24–1.70), and elective (aOR 1.50, 95% CI 1.25–1.79) and emergency caesarean section (aOR 1.35, 95% CI 1.13–1.61). Multiple exacerbations were associated with a 2.6-fold increased odds of SGA (95% CI 1.38–4.82). Amongst women treated prepregnancy with combination therapy (proxy for moderate–severe asthma), exacerbators were at increased odds of elective (aOR 1.69, 95% CI 1.30–2.2) and emergency (aOR 1.62, 95% CI 1.26–2.08) caesarean section, and SGA (aOR 1.74, 95% CI 1.18–2.57) versus non-exacerbators. Maternal asthma exacerbations increase the risk of SGA and caesarean sections, particularly in women with multiple exacerbations or moderate–severe asthma. Adequate antenatal asthma care is needed to reduce exacerbations and reduce risks of poor outcomes.
Insulin-like growth factor I stimulates apical sodium/hydrogen exchange in human proximal tubule cells
Publisher: American Physiological Society
Date: 04-1997
DOI: 10.1152/AJPRENAL.1997.272.4.F484
Abstract: To determine whether insulin-like growth factor I (IGF-I) stimulated apical sodium/hydrogen exchange (NHE), confluent primary human proximal tubule cells (PTC) were incubated for 48 h in serum-free media in the presence or absence of 100 ng/ml IGF-I. Cells incubated in IGF-I demonstrated significant increases in thymidine incorporation (181.2 +/- 30.3% of control values n = 12, P = 0.01) and in resting intracellular pH (pHi) (7.52 +/- 0.08 vs. 7.30 +/- 0.06 n = 20, P 0.05), as determined by 2',7'-bis(carboxyethyl)-5(6)-carboxyfluorescein quantitative microspectrofluorometry. Following intracellular acid loading, ethylisopropylamiloride (EIPA)-inhibitable H+ efflux and 22Na+ influx after 1 min were both significantly enhanced in IGF-I-treated cells compared with controls (8.78 +/- 1.69 vs. 3.03 +/- 0.72 mM/min and 3.47 +/- 0.49 vs. 1.55 +/- 0.35 nmol x mg protein(-1) x min(-1), respectively). 22Na+ uptake studies in PTC grown on permeable supports demonstrated preferential stimulation of apical vs. basolateral NHE. The 50% inhibitory concentrations (IC50) in IGF-I-treated and control cells for EIPA (0.5 and 1.1 microM, respectively) and for HOE-694 (4.0 and 10.0 microM, respectively) were also consistent with predominant activation of apical, rather than basolateral, NHE activity. Kinetic analysis revealed an increase in maximal transport velocity (Vmax, 15.50 +/- 1.50 vs. 7.26 +/- 3.07 mM/min n = 10, P 0.05), without a significant change in antiporter affinity for extracellular Na+. Incubation of PTC with 100 ng/ml IGF-I produced an acute, reversible, and EIPA-inhibitable pHi increase of 0.05 +/- 0.01 pH units (n = 5, P 0.05). The results suggest that IGF-I may contribute to the metachronous stimulation of apical NHE and PTC growth observed in many physiological and pathological conditions involving the human kidney.
The MOWER (middle of the week everyone gets a re-chart) pilot study: reducing in-hospital charting error with a multi-intervention
Publisher: Springer Science and Business Media LLC
Date: 20-06-2019
Breastfeeding and snoring: a birth cohort study
Publisher: Public Library of Science (PLoS)
Date: 08-01-2014
Systematic review and meta-analysis investigating breast feeding and childhood wheezing illness
Publisher: Wiley
Date: 25-08-2011
Longitudinal depression or anxiety in mothers and offspring asthma: a Swedish population-based study
Publisher: Oxford University Press (OUP)
Date: 23-09-2017
DOI: 10.1093/IJE/DYX208
Risk factors for multisystem inflammatory syndrome in children – A population-based cohort study of over 2 million children
Publisher: Elsevier BV
Date: 08-2022
Men, suicide, and family and interpersonal violence: A mixed methods exploratory study
Publisher: Wiley
Date: 02-05-2022
Abstract: Research has shown a link between gender, violence, and suicide. This relationship is complex, and few empirical studies have explored suicide and family and interpersonal violence perpetrated by men. Drawing on a coronial dataset of suicide cases and a mixed methods design, this study integrated a quantitative analysis of 155 suicide cases with a qualitative analysis of medico‐legal reports from 32 cases. Findings showed different types and patterns of family and intimate partner violence for men who died by suicide. Men used violence in response to conflict, but also to dominate women. Cumulative, interwoven effects of violence, mental illness, alcohol and other drug use, socioeconomic, and psychosocial circumstances were observed in our study population. However, the use of violence and suicidal behaviour was also a deliberate and calculated response by which some men sought to maintain influence or control over women. Health and criminal justice interventions served as short‐term responses to violence, mental illness, and suicidal behaviour, but were of limited assistance.
Asthma and all-cause mortality in children and young adults - a Swedish population based study
Publisher: European Respiratory Society
Date: 28-09-2019
Parental socioeconomic status and asthma in children: Using a population‐based cohort and family design
Publisher: Wiley
Date: 02-11-2022
DOI: 10.1111/CEA.14037
Abstract: The observed association between the parental socioeconomic status (SES, measured as education/income) and asthma or wheezing in offspring may be explained by confounding of unmeasured factors (shared genes and family environment). We aimed to study the association between parental SES and asthma/wheeze using cousin comparison. Data were collected on in iduals born in Sweden 2001–2013. Parental SES (education and income) was gathered from Statistics Sweden. Asthma/wheeze was identified using national health registers. The association between parental SES at birth and incident asthma/wheeze was estimated using Cox regression also comparing differently exposed cousins. The association between parental SES at 5 years and current asthma was estimated using logistic regression. Included were 955,371 in iduals. Mothers with compulsory school only (lowest education group) compared with those with further education (highest education group) was associated with incident asthma/wheeze below 1 year of age HRadj = 1.45 (1.38–1.52) and over 1 year of age HRadj = 1.17 (1.13–1.20). The corresponding estimates for the lowest income group were HRadj = 1.61 (1.54–1.69) and HRadj = 0.94 (0.92–0.97), respectively. In maternal cousin comparisons, the associations for asthma/wheeze over 1 year of age was HRadj = 1.21 (1.05–1.40) for compulsory school only and HRadj = 0.94 (0.84–1.07) for the lowest income group. The ORadj for current asthma at 5 years was 1.05 (1.00–1.11) for mother's compulsory school only and 0.98 (0.94–1.02) for mother's lowest income group. Results for estimates were similar for father's SES. We confirm an association between low parental SES (measured as education) and asthma/wheeze. Cousin comparison suggests that this association is not wholly due to confounding of unknown familial factors, therefore supporting a causal relationship. The relationship between parental income and asthma/wheeze is less clear. This study is important for understanding risk factors for asthma/wheeze and for future prevention strategies. Further research is warranted to investigate the possible mechanisms for association between parental education and asthma/wheeze.
Agreement between asthma questionnaire and health care register data
Publisher: Wiley
Date: 03-06-2018
DOI: 10.1002/PDS.4566
Abstract: Risk factors and consequences of asthma can be studied by using validated questionnaires. The overall objective of this study was to assess the agreement of parental-reported asthma-related questions regarding their children against Swedish health care registers. We linked a population-based twin cohort of 27 055 children aged 9 to 12 years to the Swedish Prescribed Drug Register, National Patient Register, and the primary care register. Parent-reported asthma was obtained from questionnaires, and diagnoses and medication were retrieved from the registers. For the agreement between the questionnaire and the registers, Cohen's kappa was estimated. The kappa of the "reported ever asthma" against a "register-based ever asthma" was 0.69 and 0.57 between the parental-"reported doctor's diagnosis" and "register-based doctor's diagnosis." The highest agreement between "reported current asthma" and "register-based current asthma" with at least 1 dispensed medication or a diagnosis applied to different time windows was seen for an 18-month window (kappa = 0.70). We found that parent-reported asthma-related questions showed on average good agreement with the Swedish health care registers. This implies that in-depth questionnaires with rich information on phenotypes are suitable proxies for asthma in general and can be used for health care research purposes.
Mode of delivery and offspring atopic dermatitis in a Swedish nationwide study
Publisher: Wiley
Date: 2023
DOI: 10.1111/PAI.13904
Abstract: Atopic dermatitis is a common chronic childhood disease associated with significant morbidity and healthcare costs. There is a known association between caesarean section and asthma, but the relationship between caesarean section and offspring atopic dermatitis remains uncertain. We conducted a register‐based nationwide cohort study including children born in Sweden between January 2006 and December 2018. Data on health and socioeconomic variables were extracted from the national registers for children aged ≤5 years. Time‐to‐event analyses were used to calculate hazard ratios (HR) with 95% confidence intervals (CI) adjusting for confounders and familial factors. 1,399,406 children were included (6,029,542 person‐years at risk). Atopic dermatitis was observed in 17.2% of the 1,150,896 children born by vaginal delivery and 18.3% of the 248,510 born by caesarean section. The mean age of onset of atopic dermatitis was 2.72 years (SD 1.8). Birth by caesarean section was associated with a higher risk of atopic dermatitis (adj‐HR 1.12, 95% CI: 1.10–1.14). A higher risk of atopic dermatitis was found in children born by instrumental vaginal delivery (adj‐HR 1.10, 1.07–1.13) emergency caesarean section (adj‐HR 1.12, 1.10–1.15), and elective caesarean section (adj‐HR 1.13, 1.10–1.16) than uncomplicated vaginal delivery in children year of age. Similar hazards were observed in those ≥1 year of age. In sibling control analysis, greater risks remained in children aged year but not in age ≥1 year. In our study population, it was observed that children born by caesarean section or instrumental vaginal delivery were at higher risk of early childhood atopic dermatitis. Although familial confounding attenuates the risk in children aged ≥1 year, this was not observed in the first year of life.
Breastfeeding, asthma, and allergy: a tale of two cities
Publisher: Wiley
Date: 04-12-2011
DOI: 10.1111/J.1399-3038.2011.01229.X
Abstract: The effect of breastfeeding duration on subsequent asthma and allergy remains the subject of much controversy. To investigate whether differences in study design or disease-related exposure modification were the cause of the differences in study findings. The data from two cohorts, the Childhood Asthma Prevention Study (CAPS) from Australia and the Barn Allergi Miljo Stockholm cohort from Sweden, which had reported different findings on the association between breastfeeding and asthma, were combined. For this analysis, the definitions for breastfeeding, asthma, and allergy were harmonized. Subjects were included if they had at least one parent with wheeze or asthma and had a gestational age of more than 36 wks (combined n = 882). The risk of disease-related exposure modification was assessed using survival analysis. Breastfeeding reduced the risk of asthma at 4/5 and 8 yrs of age in children with a family history of asthma. The effect was stronger in the Swedish cohort. Breastfeeding had no effect on the prevalence of sensitization to inhaled allergens in this cohort with a family history of asthma but was a risk factor for sensitization to cow's milk, peanuts, and eggs in the CAPS cohort at 4/5 yrs and in the combined cohort at 8 yrs. There was no evidence to support the existence of disease-related exposure modification in either cohort. These findings point to the importance of harmonization of features of study design, including subject selection criteria and variable definitions, in resolving epidemiological controversies such as those surrounding the impact of breastfeeding on asthma and allergic sensitization.
Asthma exacerbations during pregnancy increase risk of adverse perinatal outcomes
Publisher: European Respiratory Society
Date: 07-09-2020
A modern approach to identifying and characterizing child asthma and wheeze phenotypes based on clinical data
Publisher: Public Library of Science (PLoS)
Date: 30-12-2019
Carotid extramedial thickness is associated with local arterial stiffness in children
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2016
Prescribed analgesics in pregnancy and risk of childhood asthma
Publisher: European Respiratory Society (ERS)
Date: 17-03-2019
DOI: 10.1183/13993003.01090-2018
Abstract: Many epidemiological studies have reported a positive association between prenatal exposure to paracetamol and childhood wheezing and asthma. We investigated whether the link between prenatal analgesic exposure and asthma/wheeze is specific to paracetamol, and whether it is causal or confounded. Using linked Swedish health register data we investigated the relation between various prescribed analgesics in pregnancy and the risk of childhood asthma/wheeze in a population of 492 999, and used negative paternal control and sibling comparison approaches to explore unmeasured confounding. After controlling for potential confounders, prescribed opioids, antimigraine drugs and paracetamol were all positively associated with childhood asthma/wheeze risk at all ages ( e.g. for asthma/wheeze at age 4 years: adjusted OR 1.39 (95% CI 1.30–1.49), 1.19 (95% CI 1.01–1.40) and 1.47 (95% CI 1.36–1.59) for opioids, antimigraine drugs and paracetamol, respectively). The results of the paternal control analysis did not suggest the presence of unmeasured confounding by genetics or shared environment. However, the sibling control analysis broadly suggested that associations between prenatal exposure to the analgesics and asthma/wheeze were confounded by specific maternal factors ( e.g. for asthma/wheeze at age 4 years: adjusted OR 0.91 (95% CI 0.62–1.31), 0.50 (95% CI 0.17–1.45) and 0.80 (95% CI 0.50–1.29) for opioids, antimigraine drugs and paracetamol, respectively). We propose that analgesic use in pregnancy does not cause childhood asthma/wheeze and that the association is confounded by unmeasured factors that are intrinsic to the mother, such as chronic pain or anxiety.
Double jeopardy-pregnancy and birth during a catastrophic bushfire event followed by a pandemic lockdown, a natural experiment
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.ENVRES.2022.113752
Abstract: From November 2019 to January 2020, eastern Australia experienced the worst bushfires in recorded history. Two months later, Sydney and surrounds were placed into lockdown for six weeks due to the COVID-19 pandemic, followed by ongoing restrictions. Many pregnant women at this time were exposed to both the bushfires and COVID-19 restrictions. To assess the impact of exposure to bushfires and pandemic restrictions on perinatal outcomes. The study included 60 054 pregnant women who gave birth between November 2017 and December 2020 in South Sydney. Exposure cohorts were based on conception and birthing dates: 1) bushfire late pregnancy, born before lockdown 2) bushfires in early-mid pregnancy, born during lockdown or soon after 3) conceived during bushfires, lockdown in second trimester 4) conceived after bushfires, pregnancy during restrictions. Exposure cohorts were compared with pregnancies in the matching periods in the two years prior. Associations between exposure cohorts and gestational diabetes, preecl sia, hypertension, stillbirth, mode of birth, birthweight, preterm birth and small for gestational age were assessed using generalised estimating equations, adjusting for covariates. A decrease in low birth weight was observed for cohort 1 (aOR 0.81, 95%CI 0.69, 0.95). Conversely, cohort 2 showed an increase in low birth weight, and increases in prelabour rupture of membranes, and caesarean sections (aOR 1.18, 95%CI 1.03, 1.37 aOR 1.21, 95%CI 1.07, 1.37 aOR 1.10 (1.02, 1.18) respectively). Cohort 3 showed an increase in unplanned caesarean sections and high birth weight babies (aOR 1.15, 95%CI 1.04, 1.27 and aOR 1.16, 95%CI 1.02, 1.31 respectively), and a decrease in gestational diabetes mellitus was observed for both cohorts 3 and 4. Pregnancies exposed to both severe climate events and pandemic disruptions appear to have increased risk of adverse perinatal outcomes beyond only experiencing one event, but further research is needed.
Maternal depressive symptoms, maternal asthma, and asthma in school-aged children
Publisher: Elsevier BV
Date: 2017
Comorbidity of atopic diseases and gastro‐oesophageal reflux: evidence of a shared cause
Publisher: Wiley
Date: 16-02-2022
DOI: 10.1111/CEA.14106
Abstract: Gastro‐oesophageal reflux disease (GERD) is the most common non‐allergic comorbidity in adults with asthma however, comorbidity with other atopic diseases such as eczema and hay fever is unclear. The objective was to assess the comorbidity of GERD with asthma and atopic diseases and to investigate possible mechanisms, including genetic and/or affective factors. A co‐twin control study harnessing 46 583 adult twins. Questionnaires on health status were linked to national patient and prescribed drug register data. Analyses tested associations of comorbidity between multiple definitions of atopic diseases (self‐report and register‐based) with GERD. Comparisons were made between unpaired, monozygotic (MZ) and dizygotic (DZ) twins to assess genetic liability. Affective traits (depression, anxiety and neuroticism) were added to models as possible explanatory factors. The risk of GERD in those with asthma was OR (odds ratio) 1.52 (95% CI 1.38, 1.68), hay fever OR 1.22 (95%CI 1.12, 1.34) and eczema OR 1.23 (95%CI 1.10, 1.38). Adjusting for affective traits completely attenuated the comorbidity associations for hay fever and eczema with GERD, and partly for asthma with GERD. Co‐twin control associations attenuated suggesting a shared cause for both GERD and atopic diseases. For ex le, all twins adjOR 1.32 (95%CI 1.00, 1.74), 0.97 (95% CI 0.76–1.23) and 1.11 (95%CI 0.85–1.45) for self‐report asthma, hay fever and eczema with GERD respectively. GERD is a common comorbidity in adults with asthma, hay fever and/or eczema. We found evidence for shared mechanisms suggesting common underlying causes that may involve affective traits requiring further investigation.
Adverse perinatal outcomes in the Australian Indigenous population, the role of asthma
Publisher: Wiley
Date: 04-2022
DOI: 10.1111/AJO.13468
Asthma and affective traits in adults: a genetically informative study
Publisher: European Respiratory Society (ERS)
Date: 07-04-2019
DOI: 10.1183/13993003.02142-2018
Abstract: Depression, anxiety and high neuroticism (affective traits) are often comorbid with asthma. A causal direction between the affective traits and asthma is difficult to determine however, there may be a common underlying pathway attributable to shared genetic factors. Our aim was to determine whether a common genetic susceptibility exists for asthma and each of the affective traits. An adult cohort from the Swedish Twin Registry underwent questionnaire-based health assessments (n=23 693) and genotyping (n=15 908). Firstly, questionnaire-based associations between asthma and affective traits were explored. This was followed by genetic analyses: 1) polygenic risk scores (PRS) for affective traits were used as predictors of asthma in the cohort, and 2) genome-wide association results from UK Biobank were used in linkage-disequilibrium score regression (LDSC) to quantify genetic correlations between asthma and affective traits. Analyses found associations between questionnaire-based asthma and affective traits (OR 1.67, 95% CI 1.50–1.86 major depression OR 1.45, 95% CI 1.30–1.61 anxiety and OR 1.60, 95% CI 1.40–1.82 high neuroticism). Genetic susceptibility for neuroticism explained the variance in asthma with a dose–response effect that is, study participants in the highest neuroticism PRS quartile were more likely to have asthma than those in the lowest quartile (OR 1.37, 95% CI 1.17–1.61). Genetic correlations were found between depression and asthma (r g =0.17), but not for anxiety or neuroticism. We conclude that the observed comorbidity between asthma and the affective traits may in part be due to shared genetic influences between asthma and depression (LDSC) and neuroticism (PRS), but not anxiety.
Associations Between Maternal Distress, Cortisol Levels, and Perinatal Outcomes
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 24-01-2022
DOI: 10.1097/PSY.0000000000001049
Abstract: Stress during pregnancy may decrease gestational age at birth and birth size. We aimed to investigate the associations between maternal subjective stress measures, salivary cortisol, and perinatal outcomes. A cohort of pregnant women ( n = 1693) was recruited from eight antenatal care clinics in Stockholm, Sweden. Questionnaires on subjective distress (perceived stress, worry, depression symptoms, sleep quality) and saliva s les for cortisol measurement (morning and evening) were collected in early and late pregnancy. Perinatal outcomes were birth weight, birth length, gestational age, and birth weight for gestational age. We used linear regression to estimate associations adjusted for maternal characteristics. All associations between subjective distress and cortisol levels were close to null and nonsignificant, for ex le, exp( β ) = 1.001 (95% confidence interval = 0.995 to 1.006) for the morning cortisol level and perceived stress in early pregnancy. Likewise, most associations between distress (subjective and cortisol) and perinatal outcomes were weak and not statistically significant, for ex le, β = 1.95 (95% confidence interval = −4.16 to 8.06) for perceived stress in early pregnancy and birth weight. An exception was a statistically significant association between birth weight for gestational age and depression symptoms in early pregnancy, with somewhat higher weight with more symptoms ( β = 0.08 95% CI = 0.04 to 0.13). The results were similar for stress in early and late pregnancy. We found no association between subjective distress and cortisol measures irrespective of when in pregnancy the measures were taken. Furthermore, we found no evidence for a longitudinal association between psychological measures of stress or cortisol with lower birth weight, birth weight for gestational age, or gestational age.
Suicide in rural Australia: A retrospective study of mental health problems, health-seeking and service utilisation
Publisher: Public Library of Science (PLoS)
Date: 21-07-2021
DOI: 10.1371/JOURNAL.PONE.0245271
Abstract: Suicide rates are higher in rural Australia than in major cities, although the factors contributing to this are not well understood. This study highlights trends in suicide and examines the prevalence of mental health problems and service utilisation of non-Indigenous Australians by geographic remoteness in rural Australia. A retrospective study of National Coronial Information System data of intentional self-harm deaths in rural New South Wales, Queensland, South Australia and Tasmania for 2010–2015 from the National Coronial Information System. There were 3163 closed cases of intentional self-harm deaths by non-Indigenous Australians for the period 2010–2015. The suicide rate of 12.7 deaths per 100,000 persons was 11% higher than the national Australian rate and increased with remoteness. Among people who died by suicide, up to 56% had a diagnosed mental illness, and a further 24% had undiagnosed symptoms. Reported diagnoses of mental illness decreased with remoteness, as did treatment for mental illness, particularly in men. The most reported diagnoses were mood disorders (70%), psychotic disorders (9%) and anxiety disorders (8%). In the six weeks before suicide, 22% of cases had visited any type of health service at least once, and 6% had visited two or more services. Medication alone accounted for 76% of all cases treated. Higher suicide rates in rural areas, which increase with remoteness, may be attributable to decreasing diagnosis and treatment of mental disorders, particularly in men. Less availability of mental health specialists coupled with socio-demographic factors within more remote areas may contribute to lower mental health diagnoses and treatment. Despite an emphasis on improving health-seeking and service accessibility in rural Australia, research is needed to determine factors related to the under-utilisation of services and treatment by specific groups vulnerable to death by suicide.
Maternal body mass index in pregnancy and offspring asthma and food allergy
Publisher: Wiley
Date: 05-07-2023
DOI: 10.1111/ALL.15803
Asthma and landscape fire smoke: A Thoracic Society of Australia and New Zealand position statement
Publisher: Wiley
Date: 15-09-2023
DOI: 10.1111/RESP.14593
Exposure to stress and air pollution from bushfires during pregnancy: Could epigenetic changes explain effects on the offspring?
Publisher: MDPI AG
Date: 13-07-2021
Abstract: Due to climate change, bushfires are becoming a more frequent and more severe phenomenon which contributes to poor health effects associated with air pollution. In pregnancy, environmental exposures can have lifelong consequences for the fetus, but little is known about these consequences in the context of bushfire smoke exposure. In this review we summarise the current knowledge in this area, and propose a potential mechanism linking bushfire smoke exposure in utero to poor perinatal and respiratory outcomes in the offspring. Bushfire smoke exposure is associated with poor pregnancy outcomes including reduced birth weight and an increased risk of prematurity. Some publications have outlined the adverse health effects on young children, particularly in relation to emergency department presentations and hospital admissions for respiratory problems, but there are no studies in children who were exposed to bushfire smoke in utero. Prenatal stress is likely to occur as a result of catastrophic bushfire events, and stress is known to be associated with poor perinatal and respiratory outcomes. Changes to DNA methylation are potential epigenetic mechanisms linking both smoke particulate exposure and prenatal stress to poor childhood respiratory health outcomes. More research is needed in large pregnancy cohorts exposed to bushfire events to explore this further, and to design appropriate mitigation interventions, in this area of global public health importance.
Late Breaking Abstract - Identifying preventable early risk factors for asthma in Indigenous children: a population cohort study in Western Australia
Publisher: European Respiratory Society
Date: 07-09-2020
Combining supervised and unsupervised models to characterize asthma phenotypes in children
Publisher: European Respiratory Society
Date: 15-09-2018
Rethinking suicide in rural australia: A study protocol for examining and applying knowledge of the social determinants to improve prevention in non-indigenous populations
Publisher: MDPI AG
Date: 16-08-2019
Abstract: Disproportionate rates of suicide in rural Australia in comparison to metropolitan areas pose a significant public health challenge. The dynamic interrelationship between mental and physical health, social determinants, and suicide in rural Australia is widely acknowledged. Advancement of this knowledge, however, remains h ered by a lack of adequate theory and methods to understand how these factors interact, and the translation of this knowledge into constructive strategies and solutions. This paper presents a protocol for generating a comprehensive dataset of suicide deaths and factors related to suicide in rural Australia, and for building a program of research to improve suicide prevention policy and practice to better address the social determinants of suicide in non-indigenous populations. The two-phased study will use a mixed-methods design informed by intersectionality theory. Phase One will extract, code, and analyse quantitative and qualitative data on suicide in regional and remote Australia from the National Coronial Information System (NCIS). Phase Two will analyse suicide prevention at three interrelated domains: policy, practice, and research, to examine alignment with evidence generated in Phase One. Findings from Phase One and Two will then be integrated to identify key points in suicide prevention policy and practice where action can be initiated.
Related Organisations
Related Funding Activities
Comorbidity And Asthma-causes And Consequences And Internet Based Treatment
Start Date: 2019
End Date: 2021
Funder: Vetenskapsrådet
View Funded ActivityMaternal Distress And Offspring Asthma
Start Date: 2015
End Date: 2016
Funder: Forskningsrådet om Hälsa, Arbetsliv och Välfärd
View Funded ActivityAcademic Outcomes Of Pediatric Asthma And Allergy
Start Date: 2018
End Date: 2019
Funder: Karolinska Institutet
View Funded Activity