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Introduction: Preeclampsia and gestational diabetes mellitus share risk factors such as obesity and increased maternal age, which have become more prevalent in recent decades. We examined changes in the prevalence of preeclampsia and gestational diabetes between 2005 and 2018 in Denmark and Alberta, Canada, and investigated whether the observed trends can be explained by changes in maternal age, parity, multiple pregnancy, comorbidity, and body mass index (BMI) over time. Material and methods: This study was a register‐based cohort study conducted using data from the Danish National Health Registers and the provincial health registers of Alberta, Canada. We included in the study cohort all pregnancies in 2005–2018 resulting in live‐born infants and used binomial regression to estimate mean annual increases in the prevalence of preeclampsia and gestational diabetes in the two populations across the study period, adjusted for maternal characteristics. Results: The study cohorts included 846 127 (Denmark) and 706 728 (Alberta) pregnancies. The prevalence of preeclampsia increased over the study period in Denmark (2.5% to 2.9%) and Alberta (1.7% to 2.5%), with mean annual increases of 0.03 (95% confidence interval [CI] 0.02–0.04) and 0.06 (95% CI 0.05–0.07) percentage points, respectively. The prevalence of gestational diabetes also increased in Denmark (1.9% to 4.6%) and Alberta (3.9% to 9.2%), with average annual increases of 0.20 (95% CI 0.19–0.21) and 0.44 (95% CI 0.42–0.45) percentage points. Changes in the distributions of maternal age and BMI contributed to increases in the prevalence of both conditions but could not explain them entirely. Conclusions: The prevalence of both preeclampsia and gestational diabetes increased significantly from 2005 to 2018, which portends future increases in chronic disease rates among affected women. Increasing demand for long‐term follow up and care will amplify the existing pressure on healthcare systems. [ABSTRACT FROM AUTHOR]

Background: Previous research has suggested that some women are at increased risk of postpartum depression (PPD) because of an extra sensitivity to fluctuating hormones before and after parturition. This may particularly apply to women with endocrine disease, characterised by a less than optimal capability to self-regulate the hormonal feedback system. Aims: To investigate if women with endocrine disease history are at increased risk of developing PPD. Method: Based on information from Danish national registers, this nationwide cohort study included 888 989 deliveries (1995–2018). Endocrine disease history was defined as thyroid disease, pre-pregnancy diabetes, polycystic ovary syndrome and/or previous gestational diabetes within 10 years before pregnancy start. PPD was defined as use of antidepressants and/or hospital contact for depression within 6 months after childbirth. Results: Among 888 989 deliveries, 4.1% had a history of endocrine disease and 0.5% had a PPD episode. Overall, women with an endocrine disease history had a 42% (risk ratio 1.42, 95% CI 1.24–1.62) higher risk of PPD when compared with women with no endocrine disease. However, we also found the reverse association, whereby women with a PPD history had a 50% (hazard ratio 1.5, 95% CI 1.4–1.6) higher risk of endocrine disease when compared with women with no PPD history. Conclusions: Women with endocrine disease history had a 40% higher risk of PPD compared with women with no endocrine disease. More attention should be given to pregnant women with endocrine disease history to increase awareness of early signs of PPD. The bi-directionality of the association points to a common underlying factor. [ABSTRACT FROM AUTHOR]

Objective To examine the risk factors for Mycobacterium tuberculosis infection (MTI) among Greenlandic children for the purpose of identifying those at highest risk of infection. Methods Between 2005 and 2007, 1797 Greenlandic schoolchildren in five different areas were tested for MTI with an interferon gamma release assay (IGRA) and a tuberculin skin test (TST). Parents or guardians were surveyed using a standardized self-administered questionnaire to obtain data on crowding in the household, parents' educational level and the child's health status. Demographic data for each child--i.e. parents' place of birth, number of siblings, distance between siblings (next younger and next older), birth order and mother's age when the child was born--were also extracted from a public registry. Logistic regression was used to check for associations between these variables and MTI, and all results were expressed as odds ratios (ORs) and 95% confidence intervals (Cls). Children were considered to have MTI if they tested positive on both the IGRA assay and the TST. Findings The overall prevalence of MTI was 8.5% (152/1797). MTI was diagnosed in 26.7% of the children with a known TB contact, as opposed to 6.4% of the children without such contact. Overall, the MTI rate was higher among Inuit children (0R:4.22; 95% CI: 1.55-11.5) and among children born less than one year after the birth of the next older sibling (0R:2.48; 95% Ch 1.33- 4.63). Self-reported TB contact modified the profile to include household crowding and low mother's education. Children who had an older MTI-positive sibling were much more likely to test positive for MTI themselves (OR: 14.2; 95% CI: 5.75-35.0) than children without an infected older sibling. Conclusion Ethnicity, sibling relations, number of household residents and maternal level of education are factors associated with the risk of TB infection among children in Greenland. The strong household clustering of MTI suggests that family sources of exposure are important. Objectif Examiner les facteurs de risque d'une infection a Mycobacterium tuberculosis (MTI) parmi les enfants groenlandais afin d'identifier ceux qui presentent le risque d'infection le plus eleve. Methodes Entre 2005 et 2007, 1797 ecoliers groenlandais de cinq regions differentes ont ete testes pour le depistage de l'infection a MTI au moyen d'un test de detection de l'interferon gamma (IGRA) et d'un test cutane a la tuberculine (TST). Une enquete a ete proposee aux parents ou aux tuteurs a l'aide d'un auto-questionnaire standardise en vue d'obtenir des donnees sur la composition des menages, le niveau d'education des parents et l'etat de sante de l'enfant. Des donnees demographiques relatives a chaque enfant--a savoir le lieu de naissance des parents, le nombre de freres et soeurs, la difference d'age entre les freres et soeurs (suivant et precedent), l'ordre de naissance et l'age de la mere a la naissance de l'enfant--ont egalement ete extraites d'un registre public. Le principe de regression logistique a ete applique pour verifier les eventuelles associations entre ces variables et l'infection a MTI. Tous les resultats etaient exprimes en odds-ratios (OR) et en intervalle de confiance a 95% (IC). Les enfants etaient consideres comme atteints de MTI si le test IGRA et le TST etaient tous les deux positifs. Resultats La prevalence globale de l'infection a MTI etait de 8,5% (152/1797). On a diagnostique une infection a MTI chez 26,7% des enfants ayant ete en contact de facon averee avec une personne atteinte de tuberculose, pour 6,4% d'enfants n'ayant pas eu un tel contact. Globalement, le taux d'infection a MTI etait plus eleve chez les enfants inuits (OR: 4,22; IC a 95%: de 1,55 a 11,5) et chez les enfants nes moins d'un an apres la naissance de l'enfant precedent (OR: 2,48; IC a 95%: de 1,33 a 4,63). Un contact declare avec une personne tuberculeuse modifiait le profil, ainsi qu'un nombre eleve de personnes au foyer et une education peu elevee de la mere. Les enfants ayant un frere ou une sceur plus age atteint d'une infection a MTI risquaient davantage d'avoir eux-memes un resultat positif au depistage de MTI (OR: 14,2; IC a 95%: de 5,75 a 35.0) que les enfants n'ayant ni frere ni soeur infecte. Conclusion L'ethnicite, les relations avec les freres et soeurs, le nombre de personnes vivant au foyer et le niveau d'education maternelle sont des facteurs associes au risque d'infection par la tuberculose parmi les enfants du Groenland. La forte concentration de l'infection a MTI dans les foyers indique que les sources familiales d'exposition sont importantes. Objetivo Examinar los factores de riesgo de la infeccion por Mycobacterium tuberculosis (IMT) en ninos groenlandeses con el fin de identificar a aquellos estan expuestos a un mayor riesgo. Metodos Entre 2005 y 2007, se analizo a 1797 ninos en edad escolar de Groenlandia en cinco zonas diferentes para detectar la presencia de la IMT mediante un analisis de liberacion de interferon gamma (IGRA, por sus siglas en ingles) y una prueba cutanea de tuberculina (PCT). Los padres o tutores respondieron a un cuestionario autoadministrado y normalizado para obtener datos sobre el numero de habitantes del hogar, el nivel educativo de los padres y el estado de salud del nino. Tambien se extrajeron datos demograficos de cada nino de un registro publico (es decir, el lugar de nacimiento de los padres, el numero de hermanos, la diferencia entre hermanos (entre el que le sigue y el que le precede), el orden de nacimiento y la edad de la madre cuando nacio el nino). Se utilizo una regresion Iogistica para comprobar las asociaciones entre estas variables y la IMT. Asimismo, todos los resultados se expresaron como cocientes de probabilidades (CP) e intervalos de confianza (IC) del 95%. Se establecio que los ninos tenian la IMT en caso de resultado positivo tanto del analisis IGRA como de la PCT. Resultados La prevalencia global de la IMT fue del 8,5% (152/1797). Se diagnostico la IMT en el 26,7% de los ninos de los que se tenia constancia de un contacto con la tuberculosis, en contraposicion con el 6,4% de estos ninos que no habian tenido dicho contacto. En general, la tasa de la IMT resulto ser mas elevada en ninos inuit (CP: 4,22; IC de195%: 1,55-11,5) y entre ninos nacidos menos de un ano despues del nacimiento del hermano que les precede (CP: 2,48; IC del 95%: 1,33-4,63). La notificacion de un contacto con la tuberculosis modificaba el perfil para incluir el numero de habitantes del hogar y el bajo nivel educativo de la madre. Los ninos que tenian un hermano mayor cuya prueba de IMT fue positiva tenian muchas mas probabilidades de que su prueba tambien ofreciese un resultado positivo (CP: 14,2; IC del 95%: 5,75-35,0) en comparacion con los niSos que no tenian un hermano mayor infectado. Conclusion La etnia, las relaciones fraternales, el numero de habitantes del hogar y el nivel de educacion materno son factores asociados al riesgo de sufrir una infeccion de tuberculosis en ninos de Groenlandia. La gran concentracion en el hogar de la IMT sugiere que las fuentes familiares de exposicion son importantes., Introduction Although Greenland has experienced steady improvement in general living standards since World War II, tuberculosis (TB) remains a major health problem throughout the country. (1,2) Overall TB incidence in [...]

Background Some 5%-15% of all women experience postpartum depression (PPD), which for many is their first psychiatric disorder. The purpose of this study was to estimate the incidence of postpartum affective disorder (AD), duration of treatment, and rate of subsequent postpartum AD and other affective episodes in a nationwide cohort of women with no prior psychiatric history. Methods and findings Linking information from several Danish national registers, we constructed a cohort of 457,317 primiparous mothers with first birth (and subsequent births) from 1 January 1996 to 31 December 2013 (a total of 789,068 births) and no prior psychiatric hospital contacts and/or use of antidepressants. These women were followed from 1 January 1996 to 31 December 2014. Postpartum AD was defined as use of antidepressants and/or hospital contact for PPD within 6 months after childbirth. The main outcome measures were risk of postpartum AD, duration of treatment, and recurrence risk. We observed 4,550 (0.6%) postpartum episodes of AD. The analyses of treatment duration showed that 1 year after the initiation of treatment for their first episode, 27.9% of women were still in treatment; after 4 years, 5.4%. The recurrence risk of postpartum AD for women with a PPD hospital contact after first birth was 55.4 per 100 person-years; for women with postpartum antidepressant medication after first birth, it was 35.0 per 100 person-years. The rate of postpartum AD after second birth for women with no history of postpartum AD was 1.2 per 100 person-years. After adjusting for year of birth and mother's age, women with PPD hospital contact after first birth had a 46.4 times higher rate (95% CI 31.5-68.4) and women with postpartum antidepressant medication after their first birth had a 26.9 times higher rate (95% CI 21.9-33.2) of a recurrent postpartum episode after their second birth compared to women with no postpartum AD history. Limitations include the use of registry data to identify cases and limited confounder control. Conclusions In this study, an episode of postpartum AD was observed for 0.6% of childbirths among women with no prior psychiatric history. The observed episodes were characterized by a relatively short treatment duration, yet the women had a notably high rate of later AD and recurrent episodes of postpartum AD. The recurrence risk of postpartum AD was markedly higher among women with PPD hospital contact after first birth compared to women with postpartum antidepressant medication after first birth. Our results underline the necessity of measures targeted at specific vulnerable groups, such as women who experience PPD as a first psychiatric episode., Author(s): Marie-Louise H. Rasmussen 1,*, Marin Strøm 1, Jan Wohlfahrt 1, Poul Videbech 2, Mads Melbye 1,3 Introduction Postpartum depression (PPD) is a nonpsychotic depressive episode occurring in the period [...]

In anticipation of licensure and introduction of rotavirus vaccine into the western market, we used modeling of national hospital registry data to determine the incidence and direct medical costs of [...]

Objectives. We sought to determine precise estimates of infant mortality rates and to describe overall trends in infant mortality in Greenland and Denmark from 1973 to 1997. Methods. We analyzed data from population-based registries of all live-born infants in Greenland and Denmark to calculate infant mortality rates from 1973 to 1997. Results. Between the periods of 1973-1977 and 1993-1997, neonatal mortality rates in Greenland declined from 20.9 per 1000 live-born infants to 15.7, and post-neonatal mortality rates declined from 20.9 per 1000 to 5.9. Infant mortality rates were significantly higher in Greenland than in Denmark, and the excess mortality was uniformly distributed over all birthweight percentiles. In Greenland, the risk of infant death was significantly lower if the mother was born outside Greenland. Conclusions. Postneonatal mortality rates in Greenland have decreased significantly during the past 25 years, but little progress has been made in decreasing neonatal mortality rates. Disparities exist among children with different maternal origins. (Am J Public Health. 2004;94:452-457)