Epidemiology and Health

Original Article

Parents’ employment and non-chromosomal congenital anomalies in Korea: a national population cohort study: Kyuwon Kim, Hoyol Jhang, Erdenetuya Bolormaa, Chae Bong Kim, Seung-Ah Choe; Epidemiol Health. 2025;47:e2025018. Published online April 10, 2025; DOI: https://doi.org/10.4178/epih.e2025018

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Abstract Summary PDF: Abstract
OBJECTIVES
We assessed the association between parents’ employment status, including industrial classification, and non-chromosomal congenital anomalies in offspring.
METHODS
We analyzed data from mothers who delivered live births between 2020 and 2022, linking their records with those of their neonates from the National Health Information Service (NHIS) database. Our analysis focused on common industrial classifications representing at least 6% of the total workforce. Congenital anomalies were identified based on neonates’ diagnostic codes. We conducted logistic regression to estimate odds ratios (ORs) of congenital anomalies by the industrial classification of mothers and their partners, adjusting for individual risk factors, with the financial industry serving as the reference category.
RESULTS
Among 338,637 women with a live birth, 148,818 (43.9%) were employed at the time of pregnancy. Employment was associated with a higher risk of congenital anomalies (OR, 1.08; 95% confidence interval [CI], 1.04 to 1.12). Within the common industrial classifications, health and social work exhibited the highest risk (OR, 1.11; 95% CI, 1.06 to 1.22) compared to the financial industry. Women employed in general hospitals showed particularly elevated risks (OR, 1.19; 95% CI, 1.04 to 1.37). Among male partners, the risk estimates were generally imprecise.
CONCLUSIONS
The study indicates that certain industries are linked with a higher risk of congenital anomalies among women workers. These findings underscore the need for enhanced safety measures in high-risk industrial settings to reduce the occurrence of congenital anomalies.; Summary

Korean summary
- 2020~2022년 출산 여성 338,637명 중 43.9%가 임신 중 고용 상태였으며, 고용된 상태는 비염색체성 선천 기형 위험 증가와 연관됨(오즈비=1.08; 95% 신뢰구간[CI] 1.04–1.12). - 산업별 분석에서 금융업을 참조 기준으로 할 때, 보건·사회복지업이 가장 높은 위험을 보였고(1.11; 95% CI 1.06–1.22), 특히 종합병원에 근무하는 여성에서 위험이 특히 높았음(1.19; 95% CI 1.04–1.37). - 남성 파트너에서는 선천 기형 위험을 높이는 산업 분류는 뚜렷하지 않았으며 위험 추정치의 신뢰 구간이 전반적으로 넓고 정밀도가 낮았음.

Key Message
- Among 338,637 women who delivered between 2020 and 2022, 43.9% were employed during pregnancy, and employment status was associated with an increased risk of non-chromosomal congenital anomalies (OR 1.08; 95% confidence interval [CI] 1.04–1.12). - Compared to the financial industry, health and social work showed the highest risk (OR 1.11; 95% CI 1.06–1.22), with women working in general hospitals exhibiting an even greater elevated risk (OR 1.19; 95% CI 1.04–1.37). - Risk estimates by industrial classification for male partners were generally imprecise, with wide confidence intervals.

Systematic Review

A meta-analysis of the association between adolescent pregnancy and the risk of gynecological cancers: Bita Azmi-Naei, Fatemeh Shahbazi, Nazanin Azmi-Naei, Jalal Poorolajal; Epidemiol Health. 2024;46:e2024094. Published online November 26, 2024; DOI: https://doi.org/10.4178/epih.e2024094

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Abstract PDF Supplementary Material: Abstract
OBJECTIVES
Despite several investigations, the association between adolescent pregnancy and gynecological cancers has yet to be conclusively established. To further explore this association, we conducted a meta-analysis of observational studies.
METHODS
We conducted a comprehensive search of databases such as PubMed, Web of Science, and Scopus to identify studies investigating the link between adolescent pregnancy and gynecologic cancers. This search continued until February 20, 2023. To assess the heterogeneity among the studies, we used the I2-statistics. We also explored the potential presence of publication bias using the Begg and Egger tests. The overall effect sizes were reported as either risk ratio or odds ratio, accompanied by a 95% confidence interval (CI), using a random-effects model.
RESULTS
From an initial pool of 25,436 studies, a total of 76 studies involving 13,991,683 participants met the predefined eligibility criteria. The analysis indicated that the overall effect size for individuals having their first pregnancy at age 20 or older, compared to those having it before age 20, was 0.54 (95% CI, 0.50 to 0.59) for cervical cancer, 0.82 (95% CI, 0.77 to 0.88) for ovarian cancer, and 0.96 (95% CI, 0.89 to 1.04) for uterine cancer.
CONCLUSIONS
Our findings suggest that experiencing one’s initial pregnancy at the age of 20 or above is associated with a significantly reduced risk of cervical and ovarian cancer. However, no significant association was found between first pregnancy at this age and uterine cancer.; Summary

Original Articles

Identifying pregnancy episodes and estimating the last menstrual period using an administrative database in Korea: an application to patients with systemic lupus erythematosus: Yu-Seon Jung, Yeo-Jin Song, Jihyun Keum, Ju Won Lee, Eun Jin Jang, Soo-Kyung Cho, Yoon-Kyoung Sung, Sun-Young Jung; Epidemiol Health. 2024;46:e2024012. Published online December 19, 2023; DOI: https://doi.org/10.4178/epih.e2024012

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study developed an algorithm for identifying pregnancy episodes and estimating the last menstrual period (LMP) in an administrative claims database and applied it to investigate the use of pregnancy-incompatible immunosuppressants among pregnant women with systemic lupus erythematosus (SLE).

METHODS

An algorithm was developed and applied to a nationwide claims database in Korea. Pregnancy episodes were identified using a hierarchy of pregnancy outcomes and clinically plausible periods for subsequent episodes. The LMP was estimated using preterm delivery, sonography, and abortion procedure codes. Otherwise, outcome-specific estimates were applied, assigning a fixed gestational age to the corresponding pregnancy outcome. The algorithm was used to examine the prevalence of pregnancies and utilization of pregnancy-incompatible immunosuppressants (cyclophosphamide [CYC]/mycophenolate mofetil [MMF]/methotrexate [MTX]) and non-steroidal anti-inflammatory drugs (NSAIDs) during pregnancy in SLE patients.

RESULTS

The pregnancy outcomes identified in SLE patients included live births (67%), stillbirths (2%), and abortions (31%). The LMP was mostly estimated with outcome-specific estimates for full-term births (92.3%) and using sonography procedure codes (54.7%) and preterm delivery diagnosis codes (37.9%) for preterm births. The use of CYC/MMF/MTX decreased from 7.6% during preconception to 0.2% at the end of pregnancy. CYC/MMF/MTX use was observed in 3.6% of women within 3 months preconception and 2.5% during 0-7 weeks of pregnancy.

CONCLUSIONS

This study presents the first pregnancy algorithm using a Korean administrative claims database. Although further validation is necessary, this study provides a foundation for evaluating the safety of medications during pregnancy using secondary databases in Korea, especially for rare diseases.

Summary

Korean summary
임산부의 약물 사용 안전성에 대한 근거 제공을 위해 실제 인구집단에서의 임신 중 약물 치료 안전성을 평가하는 청구자료 기반 연구가 중요하다. 본 연구에서는 국내 청구자료에 적용할 수 있는 임신 정의 및 임신 결과 조작적 정의 알고리즘을 개발하였다. 본 알고리즘은 임신 결과 간의 우선순위를 고려한 계층 구조를 활용하며, 조기 분만 및 초음파 검사 코드 등을 통해 최종 월경 기간을 추정하였다. 또한 알고리즘을 전신홍반루푸스 환자에 적용하여 유산, 사산 등의 유병률을 산출하고 임신 중 잠재적으로 부적절한 면역억제제 사용을 파악하여 국내 청구자료의 특성을 고려한 임신 중 약물 사용 연구의 기반을 마련하였다.

Key Message
Limited safety data for pregnant women prompted recent studies on medication during pregnancy using real-world databases. This study developed a tailored algorithm for Korean healthcare claims database, employing a hierarchy of pregnancy outcomes and incorporating pre-term delivery and sonography codes for last menstrual period estimation. Applied to systemic lupus erythematosus (SLE) patients, this study presented the prevalence and drug utilization pattern of pregnancy-incompatible immunosuppressants from preconception to pregnancy end, laying a foundation for further claims database studies on medication pregnancy safety.

Citations

Citations to this article as recorded by

Utilisation patterns of immunomodulators and pregnancy outcomes in systemic lupus erythematosus: Insights from Korean national data
Yu-Seon Jung, Yeo-Jin Song, Hyeon Ji Lee, Eunji Kim, Soo-Kyung Cho, Yoon-Kyoung Sung, Sun-Young Jung
Lupus.2025; 34(2): 140. CrossRef

Does the father’s job matter? Parental occupation and preterm birth in Korea: Taemi Kim, Eunseon Gwak, Bolormaa Erdenetuya, Jeong-Won Oh, Jung-won Yoon, Myoung-Hee Kim, Jia Ryu, Seung-Ah Choe; Epidemiol Health. 2023;45:e2023078. Published online August 24, 2023; DOI: https://doi.org/10.4178/epih.e2023078

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Limited evidence is available regarding the impact of paternal occupation and its combined effect with maternal occupation on preterm birth. Therefore, we assessed the association of maternal and paternal occupations with preterm birth.

METHODS

We used the national birth data of Korea between 2010 and 2020. Parental occupations were divided into 5 categories: (1) managers; (2) professionals, technicians, and related workers; (3) clerks and support workers; (4) service and sales workers; and (5) manual workers. A multinomial logistic regression model was used to calculate the adjusted odds ratios (aORs) of extremely, very, and moderate-to-late preterm births per occupational category considering individual risk factors.

RESULTS

For the 4,004,976 singleton births, 40.2% of mothers and 95.5% of fathers were employed. Compared to non-employment, employment was associated with a lower risk of preterm birth. Among employed mothers, service and sales occupations were associated with a higher risk of preterm birth than managerial occupations (aOR, 1.06; 95% confidence interval [CI], 1.01 to 1.10 for moderate-to-late preterm births). The father’s manual occupation was associated with a higher risk of preterm birth (aOR, 1.09; 95% CI, 1.05 to 1.13 for moderate-to-late preterm) than managerial occupations. When both parents had high-risk occupations, the risk of preterm birth was higher than in cases where only the mother or neither of the parents had a high-risk occupation.

CONCLUSIONS

Paternal occupation was associated with preterm birth regardless of maternal employment and occupation and modified the effect of maternal occupation. Detailed occupational environment data are needed to identify the paternal exposures that increase the risk.

Summary

Korean summary
본 연구는 2010년부터 2020년까지 출생신고자료를 활용하여 부모의 직업이 조산에 미치는 영향에 대해 살펴보았다. 어머니의 경우 서비스 및 판매직종에서 근무할 경우 관리자 직종에 비해 조산 위험이 높았고, 아버지의 경우 육체노동자일 경우 조산의 위험이 높아졌다. 특히 부모 모두 고위험 직업을 가질수록 한쪽만 고위험 직업을 가졌을 때보다 조산 위험이 더 높았다.

Key Message
This study explored the association between parental occupation and preterm birth using Korean national birth data from 2010 to 2020. The analysis revealed that employment was associated with a lower preterm birth risk. Among employed mothers, service and sales occupations exhibited a higher risk than managerial occupations and paternal manual occupations were associated with increased preterm birth risk. When both parents were employed in high-risk occupations, the probability of preterm birth was greater compared to cases where only one of them had such an occupation.

Citations

Citations to this article as recorded by

Association Between the Occupation of Pregnant Women’s Partners and Risks of Infant Low Birth Weight and Preterm Birth in a Prospective Birth Cohort
Sumitaka Kobayashi, Yasuaki Saijo, Hiroyoshi Iwata, Takeshi Yamaguchi, Naomi Tamura, Mariko Itoh, Maki Tojo, Yoshiya Ito, Reiko Kishi
Journal of Occupational & Environmental Medicine.2025; 67(3): 161. CrossRef

Maternal pre-pregnancy anemia and childhood anemia in Indonesia: a risk assessment using a population-based prospective longitudinal study: Fadila Wirawan, Dieta Nurrika; Epidemiol Health. 2022;44:e2022100. Published online November 1, 2022; DOI: https://doi.org/10.4178/epih.e2022100

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Anemia in children under 5 years of age is often overlooked despite its detrimental effects. The public health approach to anemia prevention includes the maternal pre-pregnancy phase. This study investigated the association between pre-pregnancy anemia and the risk of anemia in children under 5 years of age.

METHODS

This cohort study included non-pregnant women from the 2007 Indonesian Family Life Survey (IFLS) and their children under 5 in the 2014 IFLS. The anemia status of mothers and children was determined based on hemoglobin (Hb) levels using Hemocue. Mantel-Haenszel adjusted relative risks (aRRs), including risk stratification by covariates, were used for the final risk assessment.

RESULTS

In total, 637 children in the 2014 IFLS were included. The risk of having a child with anemia was 1.71-fold higher in women with pre-pregnancy anemia than in women without pre-pregnancy anemia (aRR, 1.71; 95% confidence interval [CI], 1.03 to 2.85). After risk stratification based on potential confounding variables, maternal pre-pregnancy anemia remained an independent risk factor for anemia in children who still breastfed at the time of data collection (relative risk [RR], 2.11; 95% CI, 1.16 to 3.86), in children who were given water earlier than 6 months of age (RR, 2.08; 95% CI, 1.20 to 3.61), in children of mothers with a normal or underweight pre-pregnancy body mass index (RR, 1.94; 95% CI, 1.20 to 3.14), and in children of mothers without current anemia (RR, 2.20; 95% CI, 1.21 to 3.99).

CONCLUSIONS

Pre-pregnancy anemia increased the risk of childhood anemia. A public health approach emphasizing pre-conception maternal health would enable better maternal and child morbidity risk prevention.

Summary

Key Message
Pre-pregnancy anemia increased the risk of childhood anemia by 1.7 times compared to without pre-pregnancy anemia, and increased when the child was still breastfed, given water before 6 months of age, and the mother had a normal or underweight pre-pregnancy BMI, regardless of the mother’s current no anemia status.

Citations

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Identification and treatment of iron‐deficiency anemia in pregnancy and postpartum: A systematic review and quality appraisal of guidelines using AGREE II
Victoria Mintsopoulos, Evan Tannenbaum, A. Kinga Malinowski, Nadine Shehata, Melissa Walker
International Journal of Gynecology & Obstetrics.2024; 164(2): 460. CrossRef
Effect of Booklet Education and Cadre Assistance on Iron Tablets Consumption among Anemic Pregnant Women in East Jakarta
Adhila Fayasari, Isti Istianah, Sri Fauziana
Amerta Nutrition.2024; 8(1SP): 19. CrossRef
Prevalence and risk factors of anemia in the mother–child population from a region of the Colombian Caribbean
Lisetta Del Castillo, Nora Cardona-Castro, Denis R. Whelan, John Paul Builes, Héctor Serrano-Coll, Margarita Arboleda, Juan S. Leon
BMC Public Health.2023;[Epub] CrossRef
Iron deficiency anemia in pregnant women
L. D. Belotserkovtseva, L. V. Kovalenko, V. N. Zinin, S. E. Ivannikov, M. R. Keldasova
Ural Medical Journal.2023; 22(5): 140. CrossRef
Safety monitoring of oral iron supplements in pregnant women with anemia: a multi-center observational clinical study
Chang Liu, Qianqian Zhang, Peiye Hui, Yan Wang, Guohui Li, Guangchao Cao, Zicheng Xue, Jing Zhang, Heng Zhang, Xin Huang, Jiyong Wu, Fusehng Sun, Meixing Yan
Therapeutic Advances in Drug Safety.2023;[Epub] CrossRef

Association between early antenatal care and antenatal care contacts across low-and middle-income countries: effect modification by place of residence: Paschal Awingura Apanga, Maxwell Tii Kumbeni; Epidemiol Health. 2021;43:e2021092. Published online November 2, 2021; DOI: https://doi.org/10.4178/epih.e2021092

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The relationship between receiving early antenatal care (ANC) and 8 or more antenatal contacts (ANC8+) has not been well characterised across low-and middle-income countries (LMICs). It is also unclear whether the association between early ANC and ANC8+ is modified by a woman’s place of residence. Our primary aim was to assess the relationship between early ANC and ANC8+ and to investigate whether this relationship was modified by place of residence. We also estimated the coverage of ANC8+ across LMICs.

METHODS

We analysed data on 207,388 mothers with a recent live birth using multiple indicator cluster surveys conducted between 2017 and 2020 in 30 LMICS. Modified Poisson regression with robust variance was used to evaluate the relationship between early ANC and ANC8+, whilst adjusting for country, clustering, stratification, and sampling weights. Effect modification by place of residence was assessed on additive and multiplicative scales. A meta-analysis was conducted to pool prevalence estimates of ANC8+ across all countries.

RESULTS

The overall prevalence of ANC8+ was 35.6%, ranging from 1.7% in Madagascar to 99.4% in Belarus. Early ANC was positively associated with ANC8+ (adjusted prevalence ratio [aPR], 2.61; 95% confidence interval [CI], 1.82 to 3.74). There was evidence of positive effect modification on additive (relative excess risk due to interaction, 0.39; 95% CI, 0.35 to 0.44) and multiplicative (aPR, 1.78; 95% CI, 1.08 to 2.95) scales.

CONCLUSIONS

Many LMICs may not have adopted the 2016 World Health Organization guidelines on ANC8+. Receiving early ANC was associated with a higher likelihood of ANC8+, particularly for women in rural areas.

Summary

Key Message
Our findings suggest that early antenatal care (ANC) was associated with the likelihood of receiving eight or more ANC contacts (ANC8+) among all mothers across low-and middle-income countries. This association was modified by a woman’s place of residence such that mothers living in rural areas who received early ANC had a higher prevalence of ANC8+. Public health programs, which focus on increasing the coverage of ANC8+ should encourage all pregnant women to receive early ANC, particularly those living rural areas.

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The practice of polygyny on the utilisation of reproductive health services among married women in Ghana
Maxwell Tii Kumbeni, John Ndebugri Alem, Florence Assibi Ziba, Agani Afaya, Paschal Awingura Apanga
Journal of Biosocial Science.2024; 56(4): 784. CrossRef
Time to initiation of antenatal care and its predictors among pregnant women in Ethiopia: a multilevel mixed-effects acceleration failure time model
Befekadu Tesfaye Oyato, Husen Zakir Abasimel, Derara Girma Tufa, Hana Israel Gesisa, Tewodros Getachew Tsegaye, Mukemil Awol
BMJ Open.2024; 14(4): e075965. CrossRef
Multilevel modelling of factors associated with eight or more antenatal care contacts in low and middle-income countries: findings from national representative data
Biresaw Ayen Tegegne, Adugnaw Zeleke Alem, Tsegaw Amare, Fantu Mamo Aragaw, Rediet Eristu Teklu
Annals of Medicine & Surgery.2024; 86(6): 3315. CrossRef
Determinants of Focused Antenatal Care Utilization Among Women in Simiyu Region Tanzania
Agatha F. Ngowi, Serafina Mkuwa, Laura Shirima, Frida Ngalesoni, Gasto Frumence
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Contents of antenatal care services in Afghanistan: findings from the national health survey 2018
Muhammad Haroon Stanikzai, Essa Tawfiq, Massoma Jafari, Abdul Wahed Wasiq, Mohammad Khaled Seddiq, Sheena Currie, Hadia Sayam, Ahmad Haroon Baray, Sayed Ataullah Saeedzai
BMC Public Health.2023;[Epub] CrossRef
The moderating role of partners’ education on early antenatal care in northern Ghana
Paschal Awingura Apanga, Maxwell Tii Kumbeni, James Kotuah Sakeah, Ayokunle A. Olagoke, Olufemi Ajumobi
BMC Pregnancy and Childbirth.2022;[Epub] CrossRef

COVID-19: Perspective

Maternal mental health in Africa during the COVID-19 pandemic: a neglected global health issue: Kobi V. Ajayi, Elizabeth Wachira, Obasanjo Afolabi Bolarinwa, Beulah D. Suleman; Epidemiol Health. 2021;43:e2021078. Published online October 6, 2021; DOI: https://doi.org/10.4178/epih.e2021078

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Abstract

The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted mental health and well-being around the globe. Public health measures to control the virus’s rapid spread, such as physical distancing, social isolation, lockdown, restricted movements, and quarantine, caused fear and panic in the general population. Although pandemic-related stressors have been reported, changes that occur during the perinatal period compounded by those made to obstetric care guidelines may put pregnant and postpartum mothers at an increased risk of poor mental health. While an abundance of research has examined the impact of the pandemic on maternal mental health in developed nations such as Europe and America, very few studies have done so in the African continent. Considering that Africa has prominently weak health systems, poor mental health policies and infrastructure, high poverty rates, and unreliable maternal care, the pandemic is expected to have dire consequences on maternal mental health in the region. As such, multipronged mental health interventions and strategies that consider the heterogeneity within and between African regions must be developed. Doing so will close existing and widening global health disparities to achieve the United Nations Sustainable Development Goals by 2030.

Summary

Key Message
Despite the adverse psychological impact of the COVID-19 pandemic on maternal mental health globally, little is known about its effect in Africa. As of the time of this study, only four research studies have been conducted in Nigeria, Ethiopia, and Ghana, investigating the psychological sequelae of the pandemic among pregnant and postpartum women in Africa. This study calls for urgent multipronged maternal mental health interventions and psychosocial support that consider the heterogeneity within and between African regions.

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Aragaw Asfaw Hasen, Ahmed Adem Mohammed, Mekash Ayalew Mohammed, Abubeker Alebachew Seid
Medicine.2025; 104(11): e41842. CrossRef
Prevalence of Postpartum Post-Traumatic Stress Disorder and Associated Factors Among Postnatal Mothers in Public Hospitals of Harari Region, Eastern Ethiopia 2024
Dr. Bersisa Chalchisa
Collective Journal Of PublicHealth.2025; : 01. CrossRef
Factors Influencing Compliance With Social Distancing as a Nonpharmaceutical Intervention Before Vaccine Availability During the COVID-19 Pandemic: A Cross-Sectional Study in South Korea
Ah-Ra Kim, Shin Young Park, Seong-Sun Kim, Ji-Young Lee, Sun Ha Jee, Donghyok Kwon, Heejin Kimm
Asia Pacific Journal of Public Health.2024; 36(4): 378. CrossRef
Prevalence of postpartum post-traumatic stress disorder and associated factors among postnatal mothers in West Arsi zone, South West Ethiopia, 2024: a community-based cross-sectional study
Solomon Seyife Alemu, Mohammedamin Hajure Jarso, Negeso Gebeyehu Gejo, Habtemu Jarso Hebo, Daniel Yohannes Bedecha, Firomsa Bekele, Wubishet Gezimu, Addisalem Workie Demsash, Sheleme Mengistu Teferi, Gemeda Wakgari Kitil, Geleta Nenko Dube, Awol Arega Yim
Frontiers in Psychiatry.2024;[Epub] CrossRef
Barriers and facilitators to accessing and utilising sexual and reproductive health services during the COVID-19 pandemic in Africa: a systematic review and meta-analysis
Obasanjo Afolabi Bolarinwa, Clifford Odimegwu, Kobi V. Ajayi, Tosin Olajide Oni, Rajeeb Kumar Sah, Akanni Akinyemi
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Sabrina Pilav, Abigail Easter, Sergio A. Silverio, Kaat De Backer, Sushma Sundaresh, Sara Roberts, Louise M. Howard
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Cohort Profile

Cohort profile: congenital Zika virus infection and child neurodevelopmental outcomes in the ZEN cohort study in Colombia: Maritza Gonzalez, Van T. Tong, Helena Rodriguez, Diana Valencia, Jacqueline Acosta, Margaret A. Honein, Martha L. Ospina, The ZEN Study Team; Epidemiol Health. 2020;42:e2020060. Published online August 31, 2020; DOI: https://doi.org/10.4178/epih.e2020060

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Abstract

<i>Zika en Embarazadas y Niños</i> (ZEN) is a prospective cohort study designed to identify risk factors and modifiers for Zika virus (ZIKV) infection in pregnant women, partners, and infants, as well as to assess the risk for adverse maternal, fetal, infant, and childhood outcomes of ZIKV and other congenital infections. ZIKV infection during pregnancy may be associated with longterm sequelae. In the ZEN cohort, 1,519 pregnant women and 287 partners were enrolled from 3 departments within Colombia between February 2017 and January 2018, as well as 1,108 infants born to the pregnant women who were followed to 6 months. The data include baseline questionnaires at enrollment; repeated symptoms and study follow-up questionnaires; the results of lab tests to detect ZIKV and other congenital infections; medical record abstractions; infant physical, eye, and hearing exams; and developmental screening tests. Follow-up of 850 mother-child dyads occurred at 9 months, 12 months, and 18 months with developmental screenings, physical exams, and parent questionnaires. The data will be pooled with those from other prospective cohort studies for an individual participant data meta-analysis of ZIKV infection during pregnancy to characterize pregnancy outcomes and sequelae in children.

Summary

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Pediatric Research.2025;[Epub] CrossRef
Neurodevelopmental assessment of normocephalic children born to Zika virus exposed and unexposed pregnant people
Jackeline Alger, María Luisa Cafferata, Raquel López, Lisa D. Wiggins, Allison Callejas, Mario Castillo, Jenny Fúnes, Fátima Rico, Diana Valencia, Douglas Varela, Zulma Alvarez, Mabel Berrueta, Harry Bock, Carolina Bustillo, Alejandra Calderón, Alvaro Cig
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Zika virus prevention behaviors and knowledge among male partners of pregnant people and lack of condom use as a prevention behavior from the Zika en Embarazadas y Niños (ZEN) prospective cohort study, Colombia
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BMC Research Notes.2024;[Epub] CrossRef
Zika virus knowledge, attitudes and prevention behaviors among pregnant women in the ZEN cohort study, Colombia, 2017–2018
Veronica K Burkel, Suzanne M Newton, Jacqueline Acosta, Diana Valencia, Monica Benavides, Van T Tong, Marcela Daza, Christina Sancken, Maritza Gonzalez, Kara Polen, Helena Rodriguez, Milena Borbón, Carol Y Rao, Suzanne M Gilboa, Margaret A Honein, Marta L
Transactions of The Royal Society of Tropical Medicine and Hygiene.2023; 117(7): 496. CrossRef
Epidemiology of cytomegalovirus Infection among mothers and infants in Colombia
Angelica Rico, Sheila C. Dollard, Diana Valencia, Sheryll Corchuelo, Van T. Tong, Katherine Laiton‐Donato, Minal M. Amin, Monica Benavides, Phili Wong, Suzanne Newton, Marcela Daza, Jordan Cates, Maritza Gonzalez, Laura D. Zambrano, Marcela M. Mercado, El
Journal of Medical Virology.2021; 93(11): 6393. CrossRef
Causes of Phenotypic Variability and Disabilities after Prenatal Viral Infections
Youssef A. Kousa, Reafa A. Hossain
Tropical Medicine and Infectious Disease.2021; 6(2): 95. CrossRef

Review

Rapid qualitative review of ethical issues surrounding healthcare for pregnant women or women of reproductive age in epidemic outbreaks: Patrik Hummel, Abha Saxena, Corinna Klingler; Epidemiol Health. 2018;40:e2018003. Published online January 23, 2018; DOI: https://doi.org/10.4178/epih.e2018003

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Abstract

This article describes, categorizes, and discusses the results of a rapid literature review aiming to provide an overview of the ethical issues and corresponding solutions surrounding pregnancies in epidemic outbreaks. The review was commissioned by the World Health Organization to inform responses to the Zika outbreak that began in 2015. Due to the urgency of the response efforts that needed to be informed by the literature search, a rapid qualitative review of the literature published in PubMed was conducted. The search and analysis were based on the operationalization of 3 key concepts: ethics, pregnancy, and epidemic outbreak. Ethical issues and solutions were interpreted within a principlist framework. The data were analyzed using qualitative content analysis. The search identified 259 publications, of which the full text of 23 papers was read. Of those, 20 papers contained a substantive part devoted to the topic of interest and were therefore analyzed further. We clustered the ethical issues and solutions around 4 themes: uncertainty, harms, autonomy/liberty, and effectiveness. Recognition of the identified ethical issues and corresponding solutions can inform and improve response efforts, public health planning, policies, and decision-making, as well as the activities of medical staff and counselors who practice before, during, or after an epidemic outbreak that affects pregnant women or those of reproductive age. The rapid review format proved to be useful despite its limited data basis and expedited review process.

Summary

Citations

Citations to this article as recorded by

How often is the placenta included in human pregnancy research? A rapid systematic review of the literature
Leigh A. Taylor, Kelly Gallagher, Katherine A. Ott, Alison D. Gernand
Gates Open Research.2021; 5: 38. CrossRef

Original Articles

Exposure to pistachio pesticides and stillbirth: a case-control study: Saeid Razi, Mohsen Rezaeian, Fatemeh Ghani Dehkordi, Azita Manshoori, Reza Goujani, Reza Vazirinejad; Epidemiol Health. 2016;38:e2016016. Published online April 30, 2016; DOI: https://doi.org/10.4178/epih.e2016016

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Abstract

OBJECTIVES
Stillbirth is an undesirable outcome of pregnancy. In light of the increasing use of pesticides and growing concerns about the possible health effects of agricultural pesticides, we investigated the effect of exposure to pistachio pesticides on stillbirth in pregnant mothers.

METHODS

This case-control study was conducted in Rafsanjan, Iran from 2011 to 2012. A total of 125 females who had a recent stillbirth were included as the case group, and 250 controls were selected from females who had a recent live birth. For each case, two controls with the nearest propensity score to the case were selected. Data were collected using a protocol developed by the researcher that involved interviewing respondents and reviewing their medical records. Conditional multivariate and univariate logistic regression analysis were performed and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

RESULTS

The ORs of stillbirth in mothers living in pistachio gardens and those who were exposed to sprayed pesticides, in comparison to the controls, were 14.1 (95% CI, 3.3 to 63.4) and 5.0 (95% CI, 1.2 to 28.6), respectively. No significant differences were found in stillbirth rates according to the distance between the mother’s residence and a pistachio garden or involvement in agricultural activities.

CONCLUSIONS

The results of our study showed that exposure to pistachio pesticides during pregnancy may increase the likelihood of stillbirth in mothers.

Summary

Citations

Citations to this article as recorded by

Preconception and first trimester exposure to pesticides and associations with stillbirth
Melissa A Furlong, Kimberly C Paul, Kimberly L Parra, Alfred J Fournier, Peter C Ellsworth, Myles G Cockburn, Avelino F Arellano, Edward J Bedrick, Paloma I Beamer, Beate Ritz
American Journal of Epidemiology.2025; 194(1): 44. CrossRef
Dietary zinc intake and body mass index as modifiers of the association between household pesticide exposure and infertility among US women: a population-level study
Jungao Huang, Liqin Hu, Juan Yang
Environmental Science and Pollution Research.2022; 30(8): 20327. CrossRef
Glyphosate Herbicide: Reproductive Outcomes and Multigenerational Effects
María Mercedes Milesi, Virginia Lorenz, Milena Durando, María Florencia Rossetti, Jorgelina Varayoud
Frontiers in Endocrinology.2021;[Epub] CrossRef
Pestizidrückstände in Gemüse und Obst und Outcome bei Frauen unter ART
Constanze Banz-Jansen
Gynäkologische Endokrinologie.2018; 16(2): 128. CrossRef
Perinatal exposure to a glyphosate-based herbicide impairs female reproductive outcomes and induces second-generation adverse effects in Wistar rats
María M. Milesi, Virginia Lorenz, Guillermina Pacini, María R. Repetti, Luisina D. Demonte, Jorgelina Varayoud, Enrique H. Luque
Archives of Toxicology.2018; 92(8): 2629. CrossRef

A Trial for Association between Oxidative Stress in Midterm Pregnancy and Postnatal Growth during the First Year of Life.: Hyesook Park, Young Ju Kim, Hwa Young Lee, Eun Ae Park, Nam Soo Chang, Eun Hee Ha, Bo Hyun Park, Bo Eun Lee, Ju Hee Hong; Korean J Epidemiol. 2004;26(1):17-26.

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Abstract PDF: Abstract
OBJECTIVES
We aims to construct Infant Growth Cohort for evaluating whether oxidative stress in midterm pregnancy has an adverse effect on postnatal growth.
METHODS
AND MATERIALS: From September 2001 to April 2004, we constructed an Ewha Infant Growth Cohort connected with the Ewha Pregnant Women Cohort. We excluded mother-and-child pairs in which the mother had experienced hypertension or diabetes during pregnancy and had multiple births for this study, which gave us 233 mother-and-child pairs for analysis. We measured maternal serum homocysteine and urinary 8-hydroxyguanosine (8-OHdG) and malondialdehyde (MDA) at 24~28 weeks of pregnancy, and infant weights at birth and at 6 and 12 months postnatally. We applied repeated measures ANOVA with PROC MIXED to assess the significance of differences.
RESULTS
We followed 64 and 85 infants at 6 and 12 months respectively. The mean body weights were 3146.4 g at birth, 8229.7 g at 6 months, and 1006.47 g at 12 months. The mean birth weight of infants was lower in mothers with higher homocysteine levels (third and fourth quartiles), but body weights from the first- and fourth-quartile groups of maternal homocysteine levels were lower than the others even though it was not statistically significant. Body weights at birth and at 6 months in third- and fourth-quartile groups of 8-OHdG levels were lower than the others. The body weights in the fourth quartile MDA group were significantly lower than the others at all time points.
CONCLUSIONS
Maternal oxidative stress in midterm pregnancy may cause postnatal growth retardation. But, there were high rate of follow up loss and various measurement errors. Therefore, we need to have efforts for compete follow up and valid and reliable measurements.; Summary

Epidemiologic Study for the Association between Phenol Contaminated Drinking Water and Poor Pregnancy Outcomes in Taegu City.: Jung Han Park, Ju Young Lee; Korean J Epidemiol. 2000;22(1):20-31.

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From 14 to 17 March 1991 the Nakdong River which is a major source of drinking water for Taegu was contaminated with phenol that was spilled out of a factory in Gumi industrial park. Many people who drank the contaminated water complained of various symptoms and were apprehensive of possible adverse effect to the fetus. This study was conducted to examine the effect of drinking water contaminated with phenol on pregnancy outcome in Taegu. All of livebirths and stillbriths delivered in the 5 General Hospitals in Taegu during 1 year from 1 April 1991 were included for this study. For this duration, total number of babies delivered in the 5 General Hospitals was 21,196. Among them, 77.7%(16,468) were delivered from women living in Taegu and it accounted for 47.5% of 34,688 livbirths registered in Taegu during the same period. The babies born to the women living in Taegu were divided into phenol-exposed and unexposed groups. Exposed group was the residents of the area where contaminated water was supplied and they accounted for 81.4% of the women included for this study. Unexposed group was the residents of the area where drinking water was not contaminated with phenol and they accounted for 18.6% of the study subjects. Data were abstracted from the hospital records. All the rates were adjusted for the maternal age and parity by direct method. The abortion rates for the exposed group was 1.7 per 1,000 abortions and livebirths and 1.6 for the unexposed group. The stillbirth rate for the exposed group was 10.5 per 1,000 livebirths and stillbirths 20 weeks of gestation and 9.5 for unexposed group. The early neonatal death rate(within the 1st week after birth) for the exposed group was 7.8 per 1,000 livebirths and 5.4 for the unexposed group. The perinatal death rate for the exposed group was higher as 14.1 per 1,000 livebirths and stillbirths 28 weeks of gestation than 10.8 for the unexposed group. The proportions of intrauterine growth retardation(IUGR) were 2.7% for the exposed group and 3.3% for the unexposed group. Congenital anomaly incidence rates per 1,000 livebirths was 7.4 for the exposed group and 8.4 for the unexposed group. The low birthweight incidence rate for the exposed group was 6.6% and 6.5% for the unexposed group. These differences between two groups were not statistically significant. The premature birth rate(< 37 completed gestational week) was 6.0% for the exposed group and 4.8% for the unexposed group and the difference was statistically significant(p<0.05). Monthly variation of these indices did not show any clue that suggested concurrent change with the phenol contamination of the drinking water. There were no sufficient evidence that could support the hypothesis of adverse effects of phenol contaminated water on pregnancy outcome, such as abortion, stillbirth, premature birth, IUGR, congenital anomalies and early neonatal death.; Summary

Reproductive Factors Related to Serum Estrogen, Progesterone, and Sex Hormone Binding Globulin in Postmenopausal Women in Korea.: Chul Hwan Kim, Sue Kyung Park, Heon Kim, Mi Na Ha, Hai Rim Shin, Bu Ok Lee, Dae Sung Kim, Dae Hee Kang, Keun Young Yoo; Korean J Epidemiol. 1998;20(1):70-81.

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Abstract PDF: Abstract
The etiology of breast cancer is not yet clear. Several epidemiologic studies have supported the concepts that endogenous female sex hormones, i.e., estrogen and progesterone, may play a central role in the development of breast cancer. Female reproductive factors such as menstruation, pregnancy, and breast feeding are well-known risk factors of breast cancer. There have been many suggestions that all these factors are midiated by female sex hormeones. However, only a few studies have evaluated the relationship between the reproductive factors and endogenous female sex hormones. This study was designed to evaluate the relationship between the reproductive factors and endogenous female sex hormones in Korean women. We analyzed the relationship between reproductive factors and female sex hormones in 153 premenopausal women 153 postmenopausal women who participated in a community health promotion program in Haman County, Korea. The questionnaires about reproductive factors were completed by personal interview. Serum level of total estradiol(E2), progesterone(:g), and sex hormone binding globulin(SHBG) were measured by radioimmunoassay. There was no significant correlation between age at menarche and E2 in both premenopausal and postmenopausal groups. In postmenopausal subjects, E2 level increased significantly with the age at menopause increasing(r=0.25, p=0.009), adjusting for the potential confounding effect of both age and body mass index. There was a positive correlation between E2 and the intervals between age at menarche and age at menopause(r=0.25, p=0.009). Moreover, the serum level of SHBG was significantly correlated with total months of breast feeding(r=0.19, p=0.048), as well as with age at first fullterm pregnancy(r=-0.24, p=0.01). However, Pg was correlated with none of reproductive factors in both groups. This study observed that female reproductive factors, e.g., age at menopause, breast feeding, age at first fullterm pregnancy, were correlated with serum female hormones, particularly E2 and SHBG. The results provide an evidence that the relationship between the reproductive factors and breast cancer risk may be mediated, at least in part, through serum female hormones, especially estradiol in Korean women.; Summary

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