Multiple Chronic Conditions Before Pregnancy and Risk of Adverse Maternal Health Outcomes: Population-Based Cohort Study.

Objective: To assess the risks of perinatal emergency department (ED) use, hospitalisation and severe maternal morbidity or mortality (SMM-M) associated with preconception MCC, according to the number of chronic conditions, complex MCC and co-occurring cardiometabolic conditions.

Design: Population-based cohort study.

Setting: Ontario, Canada.

Target trial emulation in paediatric research: how can causal effects be estimated from observational data?

Conducting randomised controlled trials (RCTs) in rare paediatric diseases is often impractical or prohibitively expensive. Observational data from longitudinal cohort studies, disease registries, and population-based databases exist for children and adolescents, but standard observational analyses are typically limited by bias. Target trial emulation methods can improve the quality of observational analysis, address common sources of bias, and help fill evidence gaps in paediatric clinical practice.

Pediatric infections in the first year of life following maternal biologic exposure for autoimmune disorder treatment: A systematic review.

Pregnancy induces immunologic and physiologic changes that can alter disease activity for women with autoimmune disorders (AD), and if exacerbated, may necessitate treatment. Biologics are increasingly prescribed due to their targeted effects, but transplacental transfer to the fetus may increase potential risks to the infant. This review examines the risk of infection and respiratory distress in the first year of life among infants born to women with AD using biologics during pregnancy versus infants exposed to standard therapies.

Risk predictors of severe adverse maternal outcomes in pre-eclampsia: a systematic review and meta-analysis protocol.

Introduction: Pre-eclampsia (PE) remains a major contributor to maternal morbidity and mortality globally. Early identification of risk factors and evaluation of prognostic models for severe adverse maternal outcomes are essential for improving management and reducing complications. While numerous studies have explored potential risk markers, there is still no consensus on the most reliable factors and models to use in clinical practice.

Pregnancy Complications and Risk of Autoimmune Disease in Women: A Systematic Review and Meta-Analysis.

Autoimmune diseases disproportionately impact women, and pregnancy-related events could play an underlying role. We summarized literature on the association between pregnancy complications and future risk of autoimmune disease. We systematically searched Medline, EMBASE, CINAHL Plus, and Web of Science from database inception to January 2024 for observational studies that reported on history of pregnancy complications (exposure), risk of newly diagnosed autoimmune disease (outcome), and included a comparison group of unaffected women.

Primary Cesarean delivery and future risk of maternal autoimmune disease: A population-based cohort study.

Objectives: To determine the association between primary Cesarean delivery and incident autoimmune disease in women.

Methods: We conducted a population-based cohort study of 253,901 females in Ontario, Canada with a first childbirth between 2012 and 2017 and with no pre-existing autoimmune disease. Royston-Parmar models were used to estimate the time-varying association between Cesarean delivery (28.

Maternal-newborn ABO Blood Group Congruence Among Consecutive Births and Risk of Serious Neonatal Infection: Retrospective Cohort Study.

Background: Differing ABO blood groups between a mother and her fetus may confer a lower risk of serious neonatal infection. How sensitization in the first pregnancy influences this phenomenon in a subsequent pregnancy is unclear. Accordingly, this study determined whether maternal-newborn ABO blood group incongruence in a first pregnancy further modifies the risk of serious infection in a subsequent pregnancy marked by ABO incongruency.

Gestational diabetes mellitus and subsequent cardiovascular disease in a period of rising diagnoses: Cohort study.

Introduction: Evidence suggests that gestational diabetes mellitus (GDM) is associated with subsequent cardiovascular disease; however, it is unclear what impact changes in screening and diagnostic criteria have had on the association of GDM with long-term outcomes such as cardiovascular disease. The purpose of this study was to determine the association between GDM and subsequent cardiovascular disease during a period of rising gestational diabetes diagnosis in England. Specifically, associations were compared before and after 2008, when national guidelines supporting risk factor-based screening were introduced.

Language ability and virtual mental healthcare utilisation among immigrant and refugee youth: a population-based cohort study.

Background And Objectives: The widespread adoption of virtual care during the pandemic may not have been uniform across populations, including among paediatric immigrants and refugees. We sought to examine the association between virtual mental healthcare utilisation and immigration factors.

Methods: This population-based cohort study of immigrants and refugees (3-17 years) used linked health administrative databases in Ontario, Canada (March 2020 to December 2021).

Pregnancy complications and new-onset maternal autoimmune disease.

Background: Autoimmune diseases disproportionately impact women and female-specific aspects of reproduction are thought to play a role. We investigated the time-varying association between pregnancy complications and new-onset autoimmune disease in females during the reproductive and midlife years.

Methods: We conducted a population-based cohort study of 1 704 553 singleton births to 1 072 445 females in Ontario, Canada (2002-17) with no pre-existing autoimmune disease.

Prescription Medication Use in Pregnancy in People with Disabilities: A Population-Based Cohort Study.

Individuals with disabilities may require specific medications in pregnancy. The prevalence and patterns of medication use, overall and for medications with known teratogenic risks, are largely unknown. This population-based cohort study in Ontario, Canada, 2004-2021, comprised all recognized pregnancies among individuals eligible for public drug plan coverage.

The association between reproductive history and abdominal adipose tissue among postmenopausal women: results from the Women's Health Initiative.

Study Question: What is the association between reproductive health history (e.g. age at menarche, menopause, reproductive lifespan) with abdominal adiposity in postmenopausal women?

Summary Answer: Higher visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) tissue levels were observed among women with earlier menarche, earlier menopause, and greater parity.

Use of Latent Class Analysis to Predict Intensive Care Unit Admission and Mortality in Children with a Major Congenital Anomaly.

Objective: To define major congenital anomaly (CA) subgroups and assess outcome variability based on defined subgroups.

Study Design: This population-based cohort study used registries in Denmark for children born with a major CA between January 1997 and December 2016, with follow-up until December 2018. We performed a latent class analysis (LCA) using child and family clinical and sociodemographic characteristics present at birth, incorporating additional variables occurring until age of 24 months.

Mental health of caregivers of children with medical complexity: group-based trajectory modelling.

Objective: To describe the mental health trajectories of caregivers of children with medical complexity (CMC) and explore child characteristics associated with below-average caregiver mental health.

Design: A secondary analysis of prospectively collected data from 123 caregivers of children aged <16 years with medical complexity from a multicentre randomised trial conducted from December 2016 to June 2021.

Main Outcome Measure: The Patient-Reported Outcomes Measurement Information System Global Mental Health Scale was used to measure caregivers' self-reported mental health well-being.

Hypertensive Disorders of Pregnancy in Black Women - Where Do We Go from Here?

In this issue of , Sheehy et al. report the results of a prospective cohort study that examined the association between hypertensive disorders of pregnancy (HDOP) and the risk of stroke among Black women in the United States. Using data from 42,924 participants in the Black Women's Health Study (BWHS) who were free of cardiovascular disease at baseline, they compared the rates of stroke between women with HDOP and those who did not have HDOP over a median follow-up of 22 years.

Adverse perinatal events and maternal interpregnancy weight change: A population-based observational study.

Objective: Mothers whose newborn experiences adversity may neglect their own health to care for their affected infant or following a perinatal death. Weight gain after pregnancy is one measure of maternal self-care. We measured interpregnancy weight gain among women whose child had an adverse perinatal event.