Debbie A. Lawlor

Recalibrating standard CVD risk algorithms drops high-risk classifications by ~30% and equalizes performance.

Effects of maternal and paternal smoking on offspring cardiometabolic risk factors in adulthood: a multi-method intergenerational Mendelian randomization study

Parental body mass index and offspring childhood body size and eating behaviour: A structural equation modelling analysis in the Norwegian Mother, Father and Child Cohort Study

Longitudinal adiposity trajectories in White British and Pakistani children: differential associations with maternal BMI and glycaemia

Age at menarche and adverse pregnancy and perinatal outcomes: triangulating evidence from multivariable and Mendelian randomization analyses

BACKGROUND: Observational studies have suggested that a younger age at menarche is associated with increased risks of adverse pregnancy and perinatal outcomes. However, it is unclear whether these relationships are causal. METHODS: We estimated the associations between age at menarche and 13 pre-specified pregnancy outcomes by using two approaches. We estimated observational associations in the Avon Longitudinal Study of Parents and Children (N = 9441) using multivariable regression accounting for educational attainment, ethnicity, maternal age, parity, offspring sex, and adiposity. We conducted two-sample Mendelian randomization (MR) using data from the Mendelian Randomization in Pregnancy (MR-PREG) collaboration (77 683-707 797 pregnancies) and multivariable MR (MVMR) accounting for genetically-proxied adiposity. RESULTS: Older age at menarche was associated with lower risks of hypertensive disorders of pregnancy, gestational hypertension, and preeclampsia, but accounting for adiposity attenuated these effects across approaches. For example, per 1-year older age at menarche, the odds ratio (OR) for hypertensive disorders of pregnancy was 0.88 (95% confidence interval (CI) : 0.84, 0.93) in inverse variance weighted MR and 0.95 (95% CI: 0.90, 1.01) in MVMR, while the observational association attenuated from OR = 0.91 (95% CI: 0.87, 0.94) to OR = 0.97 (95% CI: 0.93, 1.01). No clear evidence was found for the effects of age at menarche on small-for-gestational-age, low birthweight, post-term birth, or perinatal depression from either approach. For other outcomes evidence was limited by imprecision (very preterm birth, gestational diabetes) or inconsistent effects in sensitivity analyses (offspring birthweight, large-for-gestational-age, high birthweight, preterm birth). CONCLUSION: We find little robust evidence for causal effects of age at menarche on pregnancy outcomes. Effects of younger menarche on increased risks of hypertensive disorders of pregnancy may be driven by adiposity.

For triglycerides, the restricted allele score was associated with CHD (OR 1.61; 95% CI 1.00-2.59) per 1-log unit increment, whereas the restricted allele score for HDL-C was not robustly associated (OR 0.91; 95% CI 0.42-1.98).

Giving birth after assisted reproductive technologies was not associated with an increased risk of cardiovascular disease compared with conceiving without ART (AHR 0.97; 95% CI 0.91-1.02).

Women’s risk of hypertension and cardiovascular disease subtypes by number of cycles of assisted reproductive technologies: a Norwegian registry-linkage study

AIMS: To assess the risk of hypertension and cardiovascular disease (CVD) in relation to the number of assisted reproductive technologies (ART) cycles. METHODS AND RESULTS: In this registry-based study, we studied women in Norway born between 1965 and 2000 still alive and residing in Norway on 1 January 2009. ART cycles were identified according to a sequence of dispensed prescriptions relating to ART treatments. We used Cox regression to evaluate the risk of hypertension (1 611 843 women/42 292 used ART) and CVD (1 625 301 women/42 763 used ART) according to the number of ART cycles the women had undergone as a time-varying exposure, adjusting for age, education, diabetes, PCOS, endometriosis, and parity. The median follow-up time was 12 years (IQR 10-12). We conducted two analyses, first using those who had not undergone ART as reference, and subsequently using those who had undergone one ART cycle as reference. Each additional ART cycle was associated with a modest increased CVD risk (HR 1.07; 95% CI: 1.04-1.10), but no clear increased risk of hypertension (HR 1.02; 95% CI: 1.00-1.04). Elevated CVD risk was primarily driven by pulmonary embolism and deep vein thrombosis. We observed weak evidence for an increased risk among those with four or more cycles (HR 1.34; 95% CI: 0.99-1.81). Programmed frozen cycles were more strongly associated with CVD risk (HR 1.35; 95% CI: 1.18-1.55). CONCLUSION: Although a clear dose-response relationship was not observed, women who underwent ART had an increased risk of CVD, mainly driven by thromboembolism.

Effect of comprehensive tobacco control policies on maternal and child outcomes: a population-based linkage study

Process evaluation learnings from the PLAY study: recommendations for nurturing care and early childhood development interventions in under resourced contexts

Clinical utility of self-reported sleep duration and insomnia symptoms in type 2 diabetes prediction

Thermomechanical Recyclability of Acrylonitrile Styrene Acrylate in Successive Extrusion Processes

Associations of adolescent menstrual symptoms with school absences and educational attainment: analysis of a prospective cohort study

Exploring the effect of pre-clinical Alzheimer’s disease on blood pressure using Mendelian randomisation and parental dementia as an instrumental variable in UK Biobank

Exploring parental prenatal influences on child health: a multicohort study and data visualisation tool

Characterising the effects of genetic liability to autoimmune conditions on pregnancy outcomes using Mendelian Randomization

Perinatal outcomes of symptomatic chikungunya, dengue and Zika infection during pregnancy in Brazil: a registry-based cohort study

The previous literature shows mixed conclusions regarding the risk of adverse perinatal outcomes in pregnant women with symptomatic chikungunya, dengue, and Zika. We investigated this topic using a linked population-based Brazilian cohort from 2015 to 2020. The study included 6,993,395 live births. Among these, 6066 ( < 0.1%) mothers were notified with chikungunya during pregnancy, 19,022 (0.3%) with dengue, and 8396 (0.1%) with Zika. Symptomatic maternal chikungunya was associated with an increased risk of preterm birth (Hazard ratio: 1.10, 95%CI 1.01-1.22), low Apgar score 5' (1.44, 1.14-1.82), and neonatal death (1.50, 1.15-1.96). Symptomatic maternal dengue was associated with preterm birth (1.07, 1.02-1.12), low birth weight (1.10, 1.04-1.15), congenital anomalies (1.19, 1.03-1.37), and low Apgar score 5' (1.26, 1.09-1.45). Symptomatic maternal Zika was associated with all adverse birth outcomes, particularly congenital anomalies, which were over twice the risk (2.36; 1.91-2.67) compared to the unexposed group. This study provides evidence of the adverse consequences of arbovirus infections during pregnancy, including critical time windows by trimester. Our findings emphasise the importance of implementing effective measures to prevent chikungunya, dengue, and Zika infections during pregnancy and the associated adverse birth and neonatal outcomes, which may have long-term health consequences for mothers and their children.

Utilising novel Mendelian randomization approaches to investigate a potential causal effect of fetal growth on maternal cardiometabolic risk in the UK Biobank

Autogenous paneled femoral vein grafts for mycotic thoracic aortic aneurysms

Epidemiology: a partnership of technical expertise and clinical insight

Like all medical fields, epidemiology is a discipline that can be practiced effectively only in partnership with others.