7 research outputs found
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Birth outcomes for African and Caribbean babies in England and Wales: retrospective analysis of routinely collected data
Objectives: To compare mean birth weights, gestational ages and odds of preterm birth and low birth weight of live singleton babies of black African or Caribbean ethnicity born in 2005 or 2006 by mother's country of birth.
Design: Secondary analysis of data from linked birth registration and NHS Numbers for Babies data set.
Setting: Births to women in England and Wales in 2005 and 2006.
Participants: Babies of African and Caribbean ethnicity born in England and Wales in 2005ā2006, whose mothers were born in African and Caribbean countries or the UK. Birth outcomes for 51 599 singleton births were analysed.
Main outcome measures: Gestational age and birth weight.
Results: Mothers born in Eastern or Northern Africa had babies at higher mean gestational ages (39.38 and 39.41 weeks, respectively) and lower odds of preterm birth (OR=0.80 and 0.65, respectively) compared with 39.00 weeks for babies with mothers born in the UK. Babies of African ethnicity whose mothers were born in Middle or Western Africa had mean birth weights of 3327 and 3311 g, respectively. These were significantly higher than the mean birth weight of 3257 g for babies of the UK-born mothers. Their odds of low birth weight (OR=0.75 and 0.72, respectively) were significantly lower. Babies of Caribbean ethnicity whose mothers were born in the Caribbean had higher mean birth weight and lower odds of low birth weight than those whose mothers were born in the UK.
Conclusions: The study shows that in babies of African and Caribbean ethnicity, rates of low birth weight and preterm birth varied by mothers' countries of birth. Ethnicity and country of birth are important factors associated with perinatal health, but assessing them singly can mask important heterogeneity in birth outcomes within categories particularly in relation to African ethnicity. These differences should be explored further
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Linking maternity data for England 2007: methods and data quality
Maternity Hospital Episode Statistics (HES) data for 2007 were linked to birth registration and NHS Numbers for Babies (NN4B) data to bring together some key demographic and clinical data items not otherwise available at a national level. This extended the time period 2005-06, for which data had previously been linked and reported
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Linking maternity data for England, 2005-06: methods and data quality
Maternity Hospital Episode Statistics (HES) data were linked to birth registration and NHS Numbers for Babies (NN4B) data to bring together some key demographic and clinical data items not otherwise available at a national level. This project added to earlier work involving linkage of birth registration records to NN4B records
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Linking maternity data for Wales, 2005-07: methods and data quality
Background: This work formed part of a project to link data recorded routinely at birth in England and Wales to bring together socio-demographic data and data about care at birth. Birth registration data for England and Wales had already been linked to the National Health Service (NHS) Numbers for Babiesā data (NN4B) recorded when an NHS number is issued to a new baby. The data for babies born between 2005 and 2007 to mothers resident in England were then further linked to their records in the Maternity Hospital Episode Statistics (HES). This paper describes the linkage of linked birth registration and NN4B records for babies of mothers resident in Wales for 2005 to 2007 to the Patient Episode Database for Wales (PEDW) and the National Community Child Health Database (NCCHD) records.
Methods: Birth registration and NN4B records were first linked to NCCHD records, which contains data about the children born. This dataset was further linked to PEDW to obtain maternity records relating to their delivery. The linkage was carried out using pre-defined linkage algorithms. The quality of the Welsh data was assessed in terms of completeness of data and concordance of common data items in relation to birth registration wherever possible. NN4B data were used for data items not collected at birth registration, such as gestational age for live births.
Results: Around 92 per cent of registration/NN4B records for the three years could be linked to NCCHD and PEDW records. Different data fields were provided from each of the two Welsh data sources, with the common and key data items, such as birth weight and gestational age, coming from NCCHD.
Overall the percentage of missing data in NCCHD was minimal, with the exception of ethnicity which was missing from 13 per cent of records in NCCHD in 2005 but from fewer records in subsequent years. For births in 2005 and 2006, over 30 per cent of NN4B records linked to registration did not have the motherās NHS number compared with less than 1.1 per cent of NCCHD records. There was excellent agreement between the data items in linked birth registration and NN4B files and the data from NCCHD with over 95 per cent concordance in common data items. Around 99 per cent of the linked records had the same ethnic group which is not surprising as records on the child health system databases and NN4B are derived from a common data source.
Conclusion: The linkage rate for maternity data in Wales was similar to that obtained in linking registration/NN4B linked data to the Maternity HES records for England but the data were of higher quality and were more complete. Therefore, NCCHD linked to PEDW could be used to analyse birth outcomes for Wales without the need to link to birth registration and NN4B data. Nevertheless data items such as motherās country of birth and socio-economic status are recorded only at birth registration so linkage to the birth registration/NN4B dataset can generate a much fuller set of data items and enable analyses of birth outcomes by factors such as ethnicity, socio-economic status and parentsā country of birth
COVID-19 vaccination and Guillain-BarrƩ syndrome: analyses using the National Immunoglobulin Database
Vaccination against viruses has rarely been associated with Guillain-BarrƩ syndrome (GBS). An association with the COVID-19 vaccine is unknown. We performed a population-based study of National Health Service data in England and a multicentre surveillance study from UK hospitals, to investigate the relationship between COVID-19 vaccination and GBS.
Firstly, case dates of GBS identified retrospectively in the National Immunoglobulin Database from 8 December 2021 to 8 July 2021 were linked to receipt dates of a COVID-19 vaccines using data from the National Immunisation Management System in England. For the linked dataset, GBS cases temporally associated with vaccination within a 6-week risk window of any COVID-19 vaccine were identified. Secondly, we prospectively collected incident UK-wide (four nations) GBS cases from 1 January 2021 to 7 November 2021 in a separate UK multicentre surveillance database. For this multicentre UK-wide surveillance dataset, we explored phenotypes of reported GBS cases to identify features of COVID-19 vaccine-associated GBS.
996 GBS cases were recorded in the National Immunoglobulin Database from January to October 2021. A spike of GBS cases above the 2016-2020 average occurred in March-April 2021. 198 GBS cases occurred within 6 weeks of the first-dose COVID-19 vaccination in England (0.618 cases per 100,000 vaccinations, 176 ChAdOx1 nCoV-19 (AstraZeneca), 21 tozinameran (Pfizer), 1 mRNA-1273 (Moderna)). The 6-week excess of GBS (compared to the baseline rate of GBS cases 6-12 weeks after vaccination) occurs with a peak at 24 days post-vaccination; first-doses of ChAdOx1 nCoV-19 accounted for the excess. No excess was seen for second-dose vaccination. The absolute number of excess GBS cases from January-July 2021 was between 98-140 cases for first-dose ChAdOx1 nCoV-19 vaccination. First-dose tozinameran and second-dose of any vaccination showed no excess GBS risk. Detailed clinical data from 121 GBS patients were reported in the separate multicentre surveillance dataset during this timeframe. No phenotypic or demographic differences identified between vaccine-associated and non-vaccinated GBS cases occurring in the same timeframe.
Analysis of the linked NID/NIMS dataset suggests that first-dose ChAdOx1 nCoV-19 vaccination is associated with an excess GBS risk of 0.576 (95%CI 0.481-0.691) cases per 100,000 doses. However, examination of a multicentre surveillance dataset suggests that no specific clinical features, including facial weakness, are associated with vaccination-related GBS compared to non-vaccinated cases. The pathogenic cause of the ChAdOx1 nCoV-19 specific first dose link warrants further study