Conclusions: The application of strict enrolment criteria may remove the sickest and poorest patients from studies. This could be quantified through sensitivity analyses to understand the impact of varying length of gaps in enrolment on risk estimation and potential inference limitations.
GSK funded study. Outcome events were obtained from inpatient and outpatient hospital visits, and incidence rates were calculated for each chronic disease.
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Results: Approximately 5. The magnitude of bias varies greatly between different diseases. Xiaojuan Li 1 , Bruce H. Fireman 2 , Jeffrey R. Curtis 3 , David E. Raebel 6 , W.
Matthew H. Secrest 1 , Robert W. Platt 2 , Pauline Reynier 1 , Colin R. Dormuth 3 , Andrea Benedetti 2,4 and Kristian B. Filion 2,1. Background: In distributed data drug safety networks such as the Canadian Network for Observational Drug Effect Studies, some databases may be missing important confounders that are captured by other databases in the network eg, body mass index [BMI].
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In MDI, a validation database containing the variables of interest is used to develop predictive distributions from which missing values are imputed in the other databases. The risk of neonatal death has not been studied. Objectives: To investigate if fluconazole use during pregnancy is associated with increased risk of stillbirth and neonatal death. The primary outcomes were stillbirth and neonatal death associated with any fluconazole exposure during pregnancy.
A secondary analysis was conducted by fluconazole dose. Cox and Poisson regression were used to estimate hazard ratios HRs for stillbirth and risk ratios RRs for neonatal death, respectively. In analyses by fluconazole dose, the HRs for stillbirth were 0. In analyses by fluconazole dose, the RRs for neonatal death were 0. Conclusions: In this large cohort from Sweden and Norway, use of fluconazole during pregnancy was not associated with increased risk of stillbirth and neonatal death. These findings were similar for doses of fluconazole commonly used for the treatment of vaginal candidiasis and for higher doses.
These findings are reassuring but need to be interpreted considering other pregnancy safety issues with fluconazole when they are used to inform clinical care. TNFi may be associated with an increased risk of preterm birth. Adjustments were made for country, maternal characteristics, and underlying disease.
Apart from TNFi agents as a group, adalimumab, etanercept, and infliximab were studied separately. Compared with the reference, women in the general population had a lower risk of preterm birth, OR 0. Conclusions: Although all TNFi agents were associated with an increased risk of preterm birth, infliximab differed most from the reference group. Background: Maternal use of antibiotics in pregnancy has been associated with risk of obesity in offspring.
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However, it is not clear whether the risk is due to the underlying infection, antibiotic use, or both. Objectives: To disentangle the effect of maternal infection from that of maternal antibiotic use on the risk of childhood obesity. We used electronic medical records EMRs to ascertain maternal infection diagnosis, results of screening for group B streptococcus GBS , and antibiotic use during pregnancy. EMRs were also used to ascertain anthropometric measurements of offspring. Results: After controlling for confounders, maternal infection without antibiotic use during pregnancy was associated with an increased risk of childhood obesity.
We also examined the impact of maternal antibiotic use during pregnancy on childhood obesity separately for antibiotic use with or without concurrent infection diagnoses.
For antibiotic use with an underlying infection, we used the group of women who had similar infections, but did not use antibiotics, as the reference group, to remove confounding by indication. Conclusions: Both maternal infection and antibiotic use during pregnancy were independently associated with increased risk of childhood obesity. Disparities in asthma prevalence, severity, and control in pregnancy.
Evidence from two health care databases in the United States. Jacqueline M. Cohen 1 , Brian T. Bateman 2 , Krista F. Huybrechts 2 , Michael Schatz 3 , Keele E. Uncontrolled asthma has been shown to increase the risk of adverse pregnancy outcomes including growth restriction and mortality. Objectives: To describe the prevalence, severity, and control of asthma in both publicly and commercially insured pregnant women in the United States.
The study population included pregnancies ending in a live birth. We assessed maternal characteristics associated with asthma and poor asthma control. Asthma was classified as severe GINA steps 4 or 5 for The proportion of cases with poor asthma control was Poor control was associated with increasing GINA treatment steps; however, many women on mild treatment strategies GINA steps 1 and 2 and no treatment had poorly controlled asthma during pregnancy Conclusions: We identified a higher prevalence of asthma overall and more severe and poorly controlled asthma, among publicly versus privately insured pregnancies in the United States.
Factors that contribute to and the consequences of poorly controlled asthma during pregnancy should be explored further. Funding: GSK We calculated the prevalence of DMT use by trimester, age group, and calendar year of delivery. Exposure to DMTs declined by Recently approved oral DMTs were less commonly dispensed; use of dimethyl fumarate, fingolimod, and dalfampridine any time during pregnancy was observed among 51 5.
Conclusions: In our cohort, DMT use in pregnancy was rare. First generation DMTs were the most commonly dispensed in pregnancy. Data are needed to inform the safety of these products in pregnancy and lactation. Uncontrolled maternal chronic respiratory diseases in pregnancy increase the risk of anorectal malformations in offspring. Reijers 3 , Paul M. Broens 4 , Cornelius E. Sloots 5 , Arno F. However, it is currently unclear whether the medication use or the underlying condition would be responsible.
Results: We observed a higher risk among women with chronic respiratory diseases without medication use OR 2. When the latter group was studied in more detail, increased risks of ARM were found in women using rescue medication OR 2. Conclusions: The results of this study indicate that uncontrolled maternal chronic respiratory diseases in pregnancy, with or without the use of rescue medication to alleviate exacerbations, seem to be associated with ARM in offspring. Background: Thromboprophylaxis is recommended after major orthopaedic surgery to prevent the risk of deep vein thrombosis and pulmonary embolism.
Medical costs were calculated according to the collective perspective. Mean age was Young Hee Nam, Colleen M. Brensinger, Warren B. Bilker, Charles E. Leonard, Xu Han and Sean Hennessy. Background: Whether sulfonylureas increase the risk of serious bleeding when used concomitantly with warfarin is clinically important, but remains unclear. Objectives: To measure the association between serious bleeding and the concomitant use of either sulfonylureas as precipitant drugs or metformin as a negative control precipitant drug in users of warfarin object drug.
We included adults who experienced serious bleeding while receiving warfarin. Conclusions: Concomitant use of warfarin with glimepiride, glipizide, glyburide, or metformin may increase the risk of bleeding. Physicians and patients need to be carefully monitoring potential bleeding throughout the concomitant use period, especially in the late risk window, and with glipizide for ICH.
Outcomes were assessed using Cox proportional hazards regression with propensity score adjustment. Secondary outcomes included hospitalization for cardiovascular events heart failure, myocardial infarction, and stroke were evaluated separately , ketoacidosis, and amputation. No significant differences were observed in the secondary outcomes. The risk was significantly lower with R15 than VKA for major bleeding 0.
Comparative effectiveness of apixaban versus rivaroxaban for the prevention of cardiovascular diseases and recurrent venous thromboembolism.
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Propensity score matching PSM was employed to balance differences in baseline characteristics eg, age, gender, CVD and VTE risk factors, and use of other medications between the two groups. However, there was no statistically significant difference in the risk of CVD between apixaban and rivaroxaban groups HR: 0. The outcomes assessed were death, hospitalization for gastrointestinal GI bleeding, intracranial hemorrhage, and ischemic stroke.
We used inverse probability of treatment weights to correct for biases across different treatments. For the whole cohort, the weighted incidence of mortality was The incidence of GI bleeding was 8. Compared with acenocoumarol, we found an increased risk of ischemic stroke for apixaban HR: 1.
Meier 1,2,3 and Christian Meier 1. However, the impact of glycaemic control on fracture risk remains unclear. We calculated crude and adjusted odds ratios aOR , adjusting for BMI and smoking, as well as for specific diabetes complications and medications.
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DM1 and DM2 patients had a mean of 8. Comorbidities associated with microvascular and macrovascular complications of diabetes, such as diabetic retinopathy, chronic renal failure, and coronary heart failure, were all associated with an elevated fracture risk.
In our study, fracture risk in DM2 is related to microvascular and macrovascular comorbidities rather than to HbA1c levels. Multivariable analyses adjusted for baseline demographics and any comorbidity, medication use, and health care utilization factors that remained unbalanced after PS weighting.
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