Dataset Information

Gestational age and risk of venous thromboembolism from birth through young adulthood.

ABSTRACT:

Background

Preterm birth has been associated with increased risk of venous thromboembolism (VTE) in infancy, but the longer-term risk is unknown. Our aim was to examine this association from birth through young adulthood.

Methods

National cohort study of 3,571,574 individuals who were live-born in Sweden from 1973 through 2008, including 206,844 born preterm (gestational age <37 weeks), and followed up to 2010 (ages 0-38 years). The main outcome was VTE.

Results

A total of 7519 (0.2%) individuals were diagnosed with VTE in 70.8 million person-years of follow-up. Low gestational age at birth was associated with VTE in infancy (ages <1 year: adjusted hazard ratio 47.16 [95% confidence interval 21.30-104.42] for 22 to 27 weeks, 5.54 [2.53-12.12] for 28 to 33 weeks, 3.54 [2.07-6.06] for 34 to 36 weeks, 1.00 for 37 to 41 weeks [reference]), early childhood (ages 1-5 years), and young adulthood (ages 18-38 years: adjusted hazard ratio 2.76 [1.43-5.31] for 22 to 27 weeks, 1.53 [1.24-1.89] for 28 to 33 weeks, 1.24 [1.10-1.40] for 34 to 36 weeks, and 1.00 for 37 to 41 weeks [reference]), but not in late childhood (ages 6-12 years). Very preterm (<34 weeks) but not late preterm birth (34-36 weeks) was also associated with VTE in adolescence (ages 13-17 years). After further adjustment for comorbidities, these associations were attenuated, but most remained significantly elevated.

Conclusions

In this large national cohort, low gestational age at birth was associated with increased risk of VTE in infancy, early childhood, and young adulthood.

SUBMITTER: Zoller B

PROVIDER: S-EPMC10556725 | biostudies-literature | 2014 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Gestational age and risk of venous thromboembolism from birth through young adulthood.

Zöller Bengt B Li Xinjun X Sundquist Jan J Sundquist Kristina K Crump Casey C

Pediatrics 20140801 2

<h4>Background</h4>Preterm birth has been associated with increased risk of venous thromboembolism (VTE) in infancy, but the longer-term risk is unknown. Our aim was to examine this association from birth through young adulthood.<h4>Methods</h4>National cohort study of 3,571,574 individuals who were live-born in Sweden from 1973 through 2008, including 206,844 born preterm (gestational age <37 weeks), and followed up to 2010 (ages 0-38 years). The main outcome was VTE.<h4>Results</h4>A total of ...[more]

PMID: 25070308

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Project description:BackgroundWhether high cardiovascular fitness is associated with reduced risk of venous thromboembolism (VTE) is unknown. The present study aims to determine whether high cardiovascular fitness reduces the risk of VTE.MethodsA Swedish cohort of male conscripts (n = 773,925) born in 1954-1970 with no history of previous VTE were followed from enlistment (1972-1990) until 2010. Data on cardiovascular fitness using a cycle ergonometric test (maximal aerobic workload in Watt [Wmax]) at conscription were linked with national hospital register data and the Multi-Generation Register. We identified all full-siblings and first-cousin pairs discordant for maximal aerobic workload. This co-relative design allows for adjustment for familial resemblance.ResultsIn total, 3005 (0.39%) males were affected by VTE. Cardiovascular fitness estimated with Wmax was not associated with VTE risk when adjusted for body mass index (BMI). However, cardiovascular fitness estimated with Wmax/kg and adjusted for BMI was associated with reduced risk for VTE (Hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.78-0.85 per standard deviation compared with mean Wmax/kg). The association was weaker over time and also when examining discordant first cousins and full-sibling pairs.ConclusionsThese results suggest that there is a relationship between cardiovascular fitness and weight that is important for future VTE risk. Key messages Whether high cardiovascular fitness is associated with reduced risk of venous thromboembolism (VTE) is unknown. A Swedish cohort of male conscripts (n = 773,925) tested with a cycle ergometric test with no history of previous VTE were followed from enlistment (1972-1990) until 2010. Cardiovascular fitness estimated with Wmax/kg and adjusted for BMI was associated with reduced risk for VTE (HR 0.81, 95% CI 0.78-0.85). These results suggest that there is a relationship between cardiovascular fitness and weight that is important for future VTE risk.

Project description:ImportanceThe poor health outcomes associated with preterm birth are well established. However, it is less clear how small variations in gestational age, even within the term range, are associated with long-term opportunities and well-being, as measured by socioeconomic outcomes in adulthood.ObjectiveTo examine the association of gestational age at birth with educational achievement, income, and primary source of income in adulthood.Design, setting, and participantsThis Danish population-based, register-based cohort study examined all live-born singletons born in Denmark from 1982 to 1986 without congenital anomalies and who lived in Denmark at age 28 years. Data analysis was conducted from November 2, 2017, to June 15, 2018.ExposuresGestational age at birth in completed weeks (22-45 weeks).Main outcomes and measuresEducational attainment, personal income, and primary source of income at age 28 years.ResultsIn a population of 228 030 singletons (4.0% preterm, 12.1% early term; 49.4% female), 36.3% had a tertiary education at age 28 years. Among adults born at 22 to 27 weeks of gestation, 21.6% had a tertiary education, and 23.2% had an income in the highest tertile. Using 40 weeks of gestation as the reference, the adjusted odds ratio for tertiary education for individuals born at 22 to 27 weeks of gestation was 0.21 (95% CI, 0.13-0.35) and the corresponding figures for 28 to 31, 33, 36, 38, and 43 to 45 weeks of gestation were 0.45 (95% CI, 0.37-0.55), 0.67 (95% CI, 0.54-0.83), 0.84 (95% CI, 0.77-0.93), 0.85 (95% CI, 0.81-0.89), and 0.93 (95% CI, 0.83-1.04), respectively. The adjusted odds ratio for highest income tertile for individuals born at 22 to 27 weeks of gestation was 0.66 (95% CI, 0.41-1.06) and the corresponding figures for 28 to 31, 33, 36, 38, and 43 to 45 weeks of gestation were 0.80 (95% CI, 0.68-0.94), 0.77 (95% CI, 0.63-0.93), 0.89 (95% CI, 0.82-0.96), 0.95 (95% CI, 0.91-0.99), and 1.00 (95% CI, 0.91-1.12), respectively. All estimates were adjusted for sex, birth year, parity, maternal age, maternal education, and maternal country of origin.Conclusions and relevanceShorter gestational duration even within the term range was associated with poorer socioeconomic outcomes in adulthood. While adults born at 35 to 38 weeks of gestation experienced only slightly increased risk of adverse socioeconomic outcomes, this may have a significant impact on public health, since a large proportion of all children are born in these weeks.

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Project description:ImportanceMetabolic dysfunction-associated steatotic liver disease (MASLD) has become the most common chronic liver disease worldwide and is increasingly being diagnosed at younger ages, affecting more than one-third of young people with obesity.ObjectiveTo evaluate associations between perinatal conditions and risk of MASLD and associated progressive liver disease.Design, setting, and participantsThis nationwide, population-based case-control study included all biopsy-confirmed cases of MASLD in Sweden. Individuals aged 25 years or younger (hereafter, young individuals) with biopsy-proven MASLD between January 1, 1992, and December 31, 2016, were matched to up to 5 general population control individuals. Granular data on maternal and perinatal characteristics were retrieved from the Swedish Medical Birth Register. Data were analyzed from June 2023 to June 2024.ExposuresBirth weight (low [<2500 g], reference [2500 to <4000 g], or high [≥4000 g]), gestational age (GA), and birth weight for GA (small for GA [SGA; <10th percentile], appropriate for GA [10th-90th percentile], or large for GA [LGA; >90th percentile]), compared between patients and matched controls.Main outcomes and measuresThe main outcome was odds of biopsy-proven MASLD and MASLD-associated progressive liver disease (ie, liver fibrosis or cirrhosis) according to birth weight, GA, and birth weight for GA, adjusted for matching factors.ResultsIn total, 165 young individuals with biopsy-proven MASLD (median age at diagnosis: 12.0 years [IQR, 4.4-16.9 years]; 100 [60.6%] male) were matched with 717 controls. There was an association between low birth weight and future development of MASLD (adjusted odds ratio [AOR], 4.05; 95% CI, 1.85-8.88) but no association between high birth weight and odds of MASLD (AOR, 0.64; 95% CI, 0.38-1.08) compared with the reference birth weight. An association was seen for SGA (AOR, 3.36; 95% CI, 2.00-5.64) compared with appropriate size for GA (reference category) but not for LGA (AOR, 0.57; 95% CI, 0.27-1.20). Progressive liver disease was more common in individuals born with low birth weight (AOR, 6.03; 95% CI, 1.66-21.87) or SGA (AOR, 4.90; 95% CI, 2.15-11.14).Conclusions and relevanceIn this nationwide study of young individuals with biopsy-proven MASLD, low birth weight and SGA were associated with development of MASLD and progressive liver disease, suggesting a need for structured screening measures to diagnose these conditions early in high-risk individuals.

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Dataset Information

Gestational age and risk of venous thromboembolism from birth through young adulthood.

Background

Methods

Results

Conclusions

Publications

Gestational age and risk of venous thromboembolism from birth through young adulthood.

Similar Datasets

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