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Biomedical subjects

Anne-Marie Nybo Andersen

Publications and source records attributed to Anne-Marie Nybo Andersen.

At least 19 recordsLinked to original sources

Cognitive function in childhood and early adulthood and injuries later in life: the Metropolit 1953 male birth cohort.

BACKGROUND: It has been suggested that cognitive function in childhood is a modifiable risk factor for adult injury. This study examines the relationship between cognitive function measured at the age of 12 and 18 years and fatal and non-fatal injuries later in adult life. METHODS: A total of 11 532 males born in Copenhagen, Denmark in 1953 were followed from 1978 until 2001 with outcomes (death from and hospital admission for unintentional injury) obtained from national registers. At the age of 12 years, 7987 of these cohort members had completed a questionnaire, which included information on cognitive performance. In addition, cognitive test scores measured on most (90%) cohort members were retrieved from the conscription board records (18 years). RESULTS: During follow-up, 100 of the men died as a result of and 2123 had been admitted to hospital at least once for injury. Cognitive function measured at both the age of 12 and 18 years was inversely associated with any form of unintentional injury. Adjustment for educational attainment at the age of 18 years attenuated these associations but did not remove them completely. The association was most evident for falls and poisoning, while associations with other injury types were weaker and disappeared after adjustment for educational status. Cognitive function was associated with repeated hospital admissions for injuries as well as length of hospital stay. CONCLUSIONS: We found marked inverse associations between cognitive function measured in ages 12 and 18 years and adult risk of fatal or non-fatal unintentional injury. An overall increase in educational level may result in a reduction in adult injury risk.

Accidental Falls↗

[Prenatal exposure to birth control pills: risk of fetal death and congenital malformations].

About 1% of pregnant women uses oral contraceptives during the first part of their pregnancy and thereby exposes their offspring to artificial estrogens. Artificial estrogens, such as oral contraceptives, accidentally used during pregnancy may have a negative impact on the fetus. This article reviews the literature on prenatal exposure to oral contraceptives and the risk of congenital malformations and fetal death. The conclusion is that prenatal exposure to oral contraceptives may be associated with a slightly elevated risk of certain specific congenital malformations.

Abnormalities, Drug-Induced↗

Childhood social environment and risk of drug and alcohol abuse in a cohort of Danish men born in 1953.

In a 32-year follow-up study, the authors analyze how social circumstances during early life, childhood social participation, and school performance affect the risk of being admitted to a hospital or dying from a diagnosis closely related to drug or alcohol abuse in young adulthood. A total of 11,376 Danish males born in 1953, for whom data from birth certificates and conscription board examinations had been traced, were followed until 2002 through linkage to the Danish Psychiatric, National Patient, and Cause of Death registries. At age 12 years, 7,877 subjects completed a questionnaire on social participation and school performance. During follow-up, 12 percent of these were given a diagnosis indicating drug or alcohol abuse. Having a single mother and a working-class father were each associated with an increased risk of drug or alcohol abuse in adult life. At age 12 years, those who disliked school, scored low on a school test, or preferred to visit a youth club during leisure time showed a greater risk of adult substance abuse. These associations were slightly attenuated when adjusted for educational status at conscription. Deprived social circumstances during childhood, poor school performance in early adolescence, and attending a youth club seemed to be independent markers of substance abuse in adult life.

Alcoholism↗

Pica in pregnancy in a privileged population: myth or reality.

BACKGROUND: In the literature pica is reported to be prevalent in pregnant women. Most studies have focused on less privileged populations, but is pica prevalent among privileged pregnant women? METHODS: 100,000 pregnant women in the Danish National Birth Cohort were asked about pica in a food frequency questionnaire mailed in gestation week 25. RESULTS: The response rate of the questionnaire was 70% of Danish National Birth Cohort participants. Only 14 women reported to have eaten substances that were clearly not foods, i.e. 0.02% had pica in this cohort of well nourished Danish women. CONCLUSION: It seems that, in privileged populations, pica is more a myth than a reality.

Adult↗

Occupational exposure to pesticides and pregnancy outcomes in gardeners and farmers: a study within the Danish National Birth Cohort.

OBJECTIVE: We conducted a follow-up study to examine whether exposure to pesticides during pregnancy had an adverse effect on pregnancy outcomes among Danish gardeners and farmers. METHODS: Using data from the National Birth Cohort in Denmark, we identified 226 pregnancies of gardeners and 214 pregnancies of farmers during 1997 through 2003. Work activities and exposure to pesticides were reported in an interview (around 16 weeks of gestation). Totally, 62,164 other workers in the cohort served as a reference group. Pregnancy outcomes were obtained by linkage to the national registers. Cox regression was applied to analyze late fetal loss and congenital malformations, and logistic regression was used to analyze preterm birth and small for gestational age. RESULTS: There were no significant differences in the studied pregnancy outcomes between gardeners or farmers and all other workers, except for an increased risk of very preterm birth for gardeners and a favorable birth weight for farmers. With the exception of biologic approach used in gardening, neither work activities nor exposure to pesticides showed a significant increased risk of adverse birth outcomes among gardeners or farmers. CONCLUSIONS: Our data suggest little effect of occupational exposures to pesticides on pregnancy outcomes among gardeners or farmers in Denmark. The results may not apply to other countries.

Adult↗

Influence of pretreatment coping strategies on the outcome of outpatient treatment of Danish alcohol abusers.

An important issue regarding treatment for alcohol abuse is the high rate of relapse following treatment. In the research on treatment of alcohol abuse, the concept of coping has been proposed as a relevant factor in the relationship between relapse crises and treatment outcome. The present study investigated the role of pretreatment coping strategies in outcome of outpatient treatment for alcohol abuse. The pretreatment coping strategies of 136 clients receiving outpatient treatment for alcohol abuse were examined as a predictor of drinking pattern after treatment. The pretreatment coping strategies were assessed by the COPE questionnaire. Drinking pattern after treatment was assessed at follow-up one year after treatment was entered. Results indicated that some pretreatment coping strategies are identifiable as adaptive and maladaptive coping strategies, respectively, regarding successful treatment for alcohol abuse. Restraint coping was found predictive of a positive drinking pattern at follow-up while the use of alcohol to cope was found predictive of a negative drinking pattern. Furthermore, the results showed tendencies towards the possibility that some coping strategies co-operated differently with types of treatment methods.

Adaptation, Psychological↗

Effect of grandparent's and parent's socioeconomic position on mortality among Danish men born in 1953.

BACKGROUND: The adverse effect on health of poor social circumstances might accumulate not only over the lifespan of the individual but also across generations. This study examines the effect of parent's and grandparent's socioeconomic position on all-cause mortality of their adult offspring. METHODS: 2890 males born in the metropolitan area of Copenhagen, Denmark in 1953, whose mothers were interviewed for information on family social background in 1968, were followed from 1968 to 2002 for information on vital status by record linkage to the Civil Registration System. The data were analysed using Cox regression models. RESULTS: All-cause mortality from age 15 to 49 years increased 25% [95% confidence interval (CI) 13-39%] for each number of parents or grandparents from working or unknown occupational social class. Offspring mortality decreased with the number of ancestors with a secondary school education hazard ratio [HR = 0.84 (95% CI 0.76-0.93)]. When the cumulative measures of ancestor's occupation and education were included in the same model, the estimates for the effect of occupational social class [HR = 1.19 (95% CI 1.06-1.34)] and education [HR = 0.91 (95% CI 0.80-1.03)] both attenuated. These relations only changed slightly when subject's own occupational class at age 22 years was taken into account. CONCLUSION: The adverse health effects of disadvantaged social circumstances accumulate not only over an individual's lifespan but also across generations. Cumulated occupational social class of ancestors seems to be an independent predictor of mortality in adult life after adjustment for subject's own social class at age 22 years.

Denmark↗

Evidence-based investigations and treatments of recurrent pregnancy loss.

OBJECTIVE: To give an overview of currently used investigations and treatments offered to women with recurrent pregnancy loss (RPL) and, from an evidence-based point of view, to evaluate the usefulness of these interventions. DESIGN: Ten experts on epidemiologic, genetic, anatomic, endocrinologic, thrombophilic, immunologic, and immunogenetic aspects of RPL discussed methodologic problems threatening the validity of research in RPL during and after an international workshop on the evidence-based management of RPL. CONCLUSION(S): Most RPL patients have several risk factors for miscarriage, and an extensive investigation for all major factors should always be undertaken. There is an urgent need for agreement concerning the thresholds for detecting what is normal and abnormal, irrespective of whether laboratory tests or uterine abnormalities are concerned. A series of lifestyle factors should be reported in future studies of RPL because they might modify the effect of laboratory or anatomic risk factors. More and larger randomized controlled trials, including trials of surgical procedures, are urgently needed, and to achieve this objective multiple centers have to collaborate. Current meta-analyses evaluating the efficacy of treatments of RPL are generally pooling very heterogeneous patient populations and treatments. It is recommended that future meta-analyses look at subsets of patients and treatment protocols that are more combinable.

Abortion, Habitual↗

Parent's age and the risk of oral clefts.

BACKGROUND: Some malformations are clearly associated with older maternal age, but the effect of older age of the father is less certain. The aim of this study is to determine the degree to which maternal age and paternal age independently influence the risk of having a child with oral clefts. METHODS: Among the 1,489,014 live births in Denmark during 1973-1996, there were 1920 children with nonsyndromic cleft lip with or without cleft palate and 956 children with nonsyndromic cleft palate. We used logistic regression to assess the impact of parental age on the occurrence of cleft lip with or without cleft palate and cleft palate. Interaction between mother's and father's age was included in the analysis. RESULTS: Separate analyses of mother's and father's age showed that older age was associated with increased risk of both cleft lip with or without cleft palate and cleft palate only. In a joint analysis, both maternal and paternal ages were associated with the risk of cleft lip with or without cleft palate, but the contribution of each was dependent on the age of the other parent. In the analysis of cleft palate only, the effect of maternal age disappeared, leaving only paternal age as a risk factor. CONCLUSION: Both high maternal age and high paternal age were associated with cleft lip with or without cleft palate. Higher paternal age but not maternal age increased the risk of cleft palate only.

Adult↗

Maternal underweight and the risk of spontaneous abortion.

BACKGROUND: To evaluate the risk of spontaneous abortion in relation to maternal pre-pregnant underweight. METHODS: The study was designed as a cohort study within the framework of the Danish National Birth Cohort (DNBC). The participants were a total of 23 821 women recruited consecutively to the DNBC from October 1, 1997 to March 31, 1999 and interviewed subsequently. The pregnant women were recruited in first half of pregnancy and interviewed about pre-pregnant body size, obstetric history, exposures in pregnancy, and socio-demographic factors. Pregnancies were followed-up regarding spontaneous abortion. Relative risk of spontaneous abortion was calculated as Hazard Ratios using Cox regression with delayed entry. RESULTS: The outcome measure was spontaneous abortion. The hazard ratio for spontaneous abortion in women with a pre-pregnant body mass index (BMI) below 18.5 was 1.24 (95% confidence limits 0.95-1.63) compared to women with pre-pregnant BMI 18.5-24.9. Women with a BMI of 25 or more had a smaller increase in risk of spontaneous abortion. Adjustment for maternal age, parity, previous miscarriages, and lifestyle factors did not affect the estimates substantially, neither did exclusion of women with metabolic or eating disorders. CONCLUSION: These results indicate that pre-pregnant underweight may affect the risk of spontaneous abortion negatively.

Abortion, Spontaneous↗

Childhood intelligence in relation to adult coronary heart disease and stroke risk: evidence from a Danish birth cohort study.

While recent studies have reported an inverse relation between childhood intelligence test scores and all-cause mortality in later life, the link with disease-specific outcomes has been rarely examined. Furthermore, the potential confounding effect of birthweight and childhood social circumstances is unknown. We investigated the relation of childhood intelligence with coronary heart disease (CHD) and stroke risk in a cohort of 6910 men born in 1953 in the Copenhagen area of Denmark. Events were ascertained from 1978 to 2000 using a cause-of-death register and hospital discharge records. There were 150 CHD (19 fatal; 131 non-fatal) and 93 stroke (4 fatal; 89 non-fatal) events during follow-up into mid-life. Childhood intelligence was inversely related to CHD with the highest rate apparent in adults with low childhood test scores (HR(lowest vs. highest quartile), 2.70; 95% confidence interval: 1.60, 4.57; P(trend) = 0.0001). After adjustment for paternal social class and birthweight, this association was attenuated only marginally. There was little evidence of a IQ-stroke relationship. The cognitive characteristics captured by IQ testing in the present study, such as communication and problem solving ability, appear to be associated with risk of CHD. Health promotion specialists and clinical practitioners may wish to consider these skills in their interactions with the general public. Replication of these results using studies which hold data on intelligence and socio-economic position across the life course is required.

Adult↗

Relation between early life socioeconomic position and all cause mortality in two generations. A longitudinal study of Danish men born in 1953 and their parents.

OBJECTIVE: To examine (1) the relation between parental socioeconomic position and all cause mortality in two generations, (2) the relative importance of mother's educational status and father's occupational status on offspring mortality, and (3) the effect of factors in the family environment on these relations. DESIGN: A longitudinal study with record linkage to the Civil Registration System. The data were analysed using Cox regression models. SETTING: Copenhagen, Denmark. SUBJECTS: 2890 men born in 1953, whose mothers were interviewed regarding family social background in 1968. The vital status of this population and their parents was ascertained from April 1968 to January 2002. MAIN OUTCOME MEASURES: All cause mortality in study participants, their mothers, and fathers. RESULTS: A similar pattern of relations was found between parental social position and all cause mortality in adult life in the three triads of father, mother, and offspring constituted of the cohort of men born in 1953, their parents, and grandparents. The educational status of mothers showed no independent effect on total mortality when father's occupational social class was included in the model in either of the triads. Low material wealth was the indicator that remained significantly associated with adult all cause mortality in a model also including parental social position and the intellectual climate of the family in 1968. In the men born in 1953 the influence of material wealth was strongest for deaths later in adult life. CONCLUSION: Father's occupational social class is associated with adult mortality in all members of the mother-father-offspring triad. Material wealth seems to be an explanatory factor for this association.

Adult↗

Psychosocial and physical work environment, and risk of pelvic pain in pregnancy. A study within the Danish national birth cohort.

OBJECTIVE: The sparse knowledge of the aetiology of pelvic pain in pregnancy makes evidence based prevention a limited option. The aim of this study was to examine the relation between pelvic pain in pregnancy and physical and psychosocial working conditions. METHODS: This study used self reported data on working conditions for 1219 cases and 1539 controls, sampled as a nested case-control study within the Danish national birth cohort. Cases and controls were selected on the basis of self reported pelvic pain intensity, pain localisation, and pain impact on daily living activities. Exposure data were collected prospectively; early in pregnancy and before the onset of pelvic pain. Main outcome measures were odds ratios for pelvic pain in pregnancy as a function of physical and psychosocial working conditions. RESULTS: Pregnant women with fixed evening work and with rotating shifts (without night shift) had odds ratios for pelvic pain in pregnancy of 1.76 (95% confidence intervals 1.04 to 2.96) and 1.65 (1.22 to 2.24), respectively, compared with women with day work. Physically strenuous work was associated with an almost 50% increased risk of pelvic pain in pregnancy (1.47; 1.17 to 1.84). In women who were under high psychosocial strain at work odds ratio was 1.39 (1.12 to 1.74) compared with women with low job strain. CONCLUSION: Both physically and psychosocially demanding working conditions, measured by physically strenuous work, rotating shifts, and high job strain, are associated with an increased reporting of pelvic pain in pregnancy.

Denmark↗

Birth dimensions and risk of depression in adulthood: cohort study of Danish men born in 1953.

BACKGROUND: Two British cohort studies have reported birth weight to be associated with self-reported depression in adulthood, even after adjustment for socio-economic factors. AIMS: To examine the relationship between birth dimensions and discharge from a psychiatric ward with a depression diagnosis in adulthood. METHOD: A cohort of 10 753 male singletons born in Copenhagen, Denmark in 1953 and for whom birth certificates had been traced in 1965 were followed from 1969 until 2002, with record linkage for date of first admission to a psychiatric ward that led to a discharge diagnosis of depression. RESULTS: A total of 190 men, corresponding to 1.8% of the cohort, had a discharge diagnosis of depression. The Cox's regression analyses failed to show any association between birth dimensions (birth weight and ponderal index) and risk of psychiatric ward diagnosis of depression in adult life, before or after adjustment for social indicators at birth. CONCLUSIONS: This study does not support the existence of a relation between birth dimensions and psychiatric ward admission for depression in adult men.

Adult↗

Time to pregnancy among Danish laboratory technicians who were a part of the National Birth Cohort.

OBJECTIVES: The Danish National Birth Cohort was used to examine whether laboratory work was associated with reduced fecundity. METHODS: Self-reported data on laboratory work and waiting time to pregnancy (0-2, 3-5, 6-12 and > 12 months) were used for 829 female laboratory technicians interviewed in 1997-2003. Altogether 6250 female teachers formed the reference group. A discrete-time survival analysis with a complementary log-log link was applied to estimate the fecundability ratio between the exposed and unexposed women, with adjustment for maternal age, gravidity, smoking, prepregnancy body mass index, and paternal job. RESULTS: No difference in time to pregnancy was found between the laboratory technicians and teachers or between the laboratory technicians with different exposures. The adjusted fecundability ratio for the laboratory technicians was 0.94 [95% confidence interval (95% CI) 0.86-1.02] for all pregnancies and 0.98 (95% CI 0.86-1.13) for first pregnancies. A healthy worker effect was found for the laboratory technicians working with the work processes under study. CONCLUSIONS: The results do not suggest that laboratory work in Denmark at present impairs female fecundity.

Adult↗

Advanced paternal age and risk of fetal death: a cohort study.

A possible detrimental paternal age effect on offspring health due to mutations of paternal origin should be reflected in an association between paternal age and fetal loss. The authors used data from a prospective study of 23,821 pregnant women recruited consecutively to the Danish National Birth Cohort from 1997 to 1999 to assess the association between paternal age and fetal death. Fathers of the pregnancies were identified by record linkage to population registers. The paternal age-related risks of fetal death and its components, early and late fetal loss, were estimated using survival analysis. Pregnancies fathered by a man aged 50 or more years (n = 124) had almost twice the risk of ending in a fetal loss compared with pregnancies with younger fathers (hazard ratio = 1.88, 95% confidence interval: 0.93, 3.82), after adjustment for maternal age, reproductive history, and maternal lifestyle during pregnancy. Various approaches to adjustment for potential residual confounding of the relation by maternal age did not affect the relative risk estimates. The paternal age-related risk of late fetal death was higher than the risk of early fetal death and started to increase from the age of 45 years. It should, however, be interpreted cautiously because of the restricted number of fetal deaths.

Abortion, Spontaneous↗