7 research outputs found

    Preterm birth in women with inflammatory bowel disease – the association with disease activity and drug treatment

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    <p><b>Background:</b> The inflammatory bowel diseases (IBD), Crohn’s disease (CD) and ulcerative colitis (UC) have been associated with an increased risk of preterm birth.</p> <p><b>Material and methods:</b> We identified all 246 singleton preterm births among women with IBD between July 2006 and December 2010 as cases and an equal number of controls with IBD from the Swedish national health registers, matched by maternal age, parity and IBD diagnosis (CD/UC). From register data and medical charts, we obtained information on reproductive history, comorbidity, disease activity and drug treatment (corticosteroids, 5-aminosalicylates, sulfasalazine, thiopurines and anti-TNF) as risk factors for preterm birth. Associations were estimated using conditional logistic regression and results were presented as odds ratios (OR) with 95% confidence intervals (CI).</p> <p><b>Results:</b> Previous preterm birth was more common among cases, OR 6.13 (95%CI: 2.51–15.01). Significant activity at any time during pregnancy (OR: 2.20; 95%CI: 1.37–3.53), and in particular both in early and in late pregnancy, was more common for cases (OR: 4.78 95%; CI: 2.10–10.9). The OR for immunosuppressive treatment with thiopurines or anti-TNF was 1.88 (1.04–3.39) without significant activity and 12.78 (95%CI: 3.68–44.72) with. The risk for women who discontinued thiopurines was 6.56 (1.44–29.82).</p> <p><b>Conclusions:</b> Significant activity and immunosuppressive treatment was associated with preterm birth, particularly in women with both. The existing recommendations to aim at maintaining quiescent disease during pregnancy, even if it means continuing immunosuppressive treatment, are rational.</p

    Month of Birth and Mortality in Sweden: A Nation-Wide Population-Based Cohort Study

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    <div><h3>Background</h3><p>Month of birth – an indicator for a variety of prenatal and early postnatal exposures – has been associated with life expectancy in adulthood. On the northern hemisphere, people born in the autumn live longer than those born during the spring. Only one study has followed a population longitudinally and no study has investigated the relation between month of birth and mortality risk below 50 years.</p> <h3>Methods and results</h3><p>In this nation-wide Swedish study, we included 6,194,745 subjects, using data from population-based health and administrative registries. The relation between month of birth (January – December) and mortality risk was assessed by fitting Cox proportional hazard regression models using attained age as the underlying time scale. Analyses were made for ages >30, >30 to 50, >50 to 80 and >80 years. Month of birth was a significant predictor of mortality in the age-spans >30, >50 to 80, and >80 years. In models adjusted for gender and education for ages >30 and >50 to 80 years, the lowest mortality was seen for people born in November and the highest mortality in those born in the spring/summer, peaking in May for mortality >30 years (25‰ excess hazard ratio compared to November, [95% confidence interval = 16–34 ]) and in April for mortality >50 to 80 years (42‰ excess hazard ratio compared to November, [95% confidence interval = 30–55]). In the ages >80 years the pattern was similar but the differences in mortality between birth months were smaller. For mortality within the age-span >30 to 50 years, results were inconclusive.</p> <h3>Conclusion</h3><p>Month of birth is associated to risk of mortality in ages above 50 years in Sweden. Further studies should aim at clarifying the mechanisms behind this association.</p> </div

    Number of deaths and excess hazard ratio (EHR) in ‰ compared to November (95% confidence interval) in the age-span >30: crude model, adjusted for sex and education, male (adjusted for education) and female (adjusted for education) and with p-value for type 3-test.

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    <p>Number of deaths and excess hazard ratio (EHR) in ‰ compared to November (95% confidence interval) in the age-span >30: crude model, adjusted for sex and education, male (adjusted for education) and female (adjusted for education) and with p-value for type 3-test.</p

    Number of deaths and excess hazard ratio (EHR) in ‰ compared to November (95% confidence interval) in the age-spans >30 to 50, >50 to 80 and >80 years: crude models and adjusted for sex and education with p-value for type 3-test.

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    <p>Number of deaths and excess hazard ratio (EHR) in ‰ compared to November (95% confidence interval) in the age-spans >30 to 50, >50 to 80 and >80 years: crude models and adjusted for sex and education with p-value for type 3-test.</p

    Number of subjects and proportion of the population that died during the study time by age-span, sex and education group.

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    <p>Number of subjects and proportion of the population that died during the study time by age-span, sex and education group.</p
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