The <scp>Stockholm–Gotland</scp> perinatal cohort—A population‐based cohort including longitudinal data throughout pregnancy and the postpartum period

Johansson, Kjell; Granfors, Michaela; Petersson, Gunilla; Bolk, Jenny; Altman, Maria; Cnattingius, Sven; Liu, Xingrong; Sandström, Anna; Stephansson, Olof

doi:10.1111/ppe.12945

Cited by 9 publications

(7 citation statements)

References 44 publications

(159 reference statements)

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“…We conducted a population-based cohort study, using data the Stockholm-Gotland Obstetric Cohort 23 . This prospective dataset includes 334,138 maternal and neonate dyads with singleton births between January 2008 and June 2020 23 .…”

Section: Methodsmentioning

confidence: 99%

First stage of labour duration and associated risk of adverse neonatal outcomes

Lundborg

Åberg

Sandström

et al. 2023

Sci Rep

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Prior evidence evaluating the benefits and harms of expectant labour duration during active first stage is inconclusive regarding potential consequences for the neonate. Population-based cohort study in Stockholm-Gotland region, Sweden, including 46,040 women (Robson 1), between October 1st, 2008 and June 15th, 2020. Modified Poisson regression was used for the association between active first stage of labour duration and adverse neonatal outcomes. 94.2% experienced a delivery with normal neonatal outcomes. Absolute risk for severe outcomes increased from 1.9 to 3.0%, moderate outcomes increased from 2.8 to 6.2% (> 10.1 h). Compared to the reference, (< 5.1 h; median), the adjusted relative risk (aRR) of severe neonatal outcome significantly increased beyond 10.1 h (> 90th percentile) (aRR 1.53, 95% CI 1.26, 1.87), for moderate neonatal outcome the aRR began to slowly increase beyond 5.1 h (≥ 50 percentile; aRR 1.40, 95% CI 1.24, 1.58). Mediation analysis indicate that most of the association was due to a longer active first stage of labour, 13% (severe neonatal outcomes) and 20% (moderate neonatal outcomes) of the risk was mediated (indirect effect) by longer second stage of labour duration. We report an association between increasing active first stage duration and increased risk of adverse neonatal outcomes. We did not observe a clear labour duration risk threshold.

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Section: Methodsmentioning

confidence: 99%

First stage of labour duration and associated risk of adverse neonatal outcomes

Lundborg

Åberg

Sandström

et al. 2023

Sci Rep

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“…Suárez‐Idueta and colleagues 2 describe the linkage of national live birth and death data from Mexico and provide estimates for neonatal, infant, and under‐5 childhood mortality according to birth characteristics. Johansson and colleagues 3 describe a unique population‐based longitudinal data source of mothers and their infants from the Stockholm and Gotland regions of Sweden that utilises information from medical records with linkage to national registers. Razaz and colleagues 4 provide a commentary that highlights the utility and limitations of using large databases in epidemiologic research and provide some data examples.…”

Section: Data Sourcementioning

confidence: 99%

The data giveth, but what do we take away?

Palmsten

2023

Paediatric Perinatal Epid

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The data giveth, but what do we take away?News media, popular periodicals, and scientific literature describe the growth in health-related data as explosive. 1 As the availability of data grows, and methods to protect the privacy and improve sharing continue to develop, clinical research and epidemiologic studies related to pregnancy and perinatal outcomes become increasingly easier to conduct. Pair these growing resources with developments in data linkage methods, as well as the simultaneously explosive uptake in data science, and the possibilities are profound. And while these developments may lead to more straightforward analyses and insights into other fields, reproductive and perinatal epidemiology lends itself to nuances that may require special considerations.Given the reality of more data, tools, and computational power, we assembled this special issue of Paediatric and Perinatal Epidemiology touching on three major areas in research, and we highlight approaches, considerations, and some limitations to this work.The first section includes data source profiles from two countries (Mexico and Sweden). The second section considers issues around data fidelity. In other words, are we studying what we intended to study (or to what extent do we have accuracy and representativeness in our data of what we expect or anticipate it to represent)? And finally, the third section highlights data analysis, where authors discuss approaches such as Mendelian randomisation and instrumental variables, machine learning, recalibration of prognostic models, and mediational g-formula methods. We discuss these issues in more detail.

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“…For this population-based cohort study, data on pregnancies and deliveries were obtained from the Stockholm-Gotland Perinatal Cohort. 27 The cohort consists of prospectively collected data automatically retrieved from the electronic medical record system Obstetrix (Cerner, Kansas City, MO, USA), covering all births in the Stockholm and Gotland regions. About one-quarter (approx.…”

Section: Study Design and Data Sourcesmentioning

confidence: 99%

Duration of the active first stage of labour and severe perineal lacerations and maternal postpartum complications: a population‐based cohort study

Kogner,

Lundborg,

Liu

et al. 2023

BJOG

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ObjectiveThe impact of first stage labour duration on maternal outcomes is sparsely investigated. We aimed to study the association between a longer active first stage and maternal complications in the early postpartum period.DesignA population‐based cohort study.SettingRegions of Stockholm and Gotland, Sweden, 2008–2020.PopulationA cohort of 159 459 term, singleton, vertex pregnancies, stratified by parity groups.MethodsThe exposure was active first stage duration, categorised in percentiles. Poisson regression analysis was performed to estimate the adjusted relative risk (aRR) and the 95% confidence interval (95% CI). To investigate the effect of second stage duration on the outcome, mediation analysis was performed.Main outcome measuresSevere perineal lacerations (third or fourth degree), postpartum infection, urinary retention and haematoma in the birth canal or ruptured sutures.ResultsThe risks of severe perineal laceration, postpartum infection and urinary retention increased with a longer active first stage, both overall and stratified by parity group. The aRR increased with a longer active first stage, using duration of <50th percentile as the reference. In the ≥90th percentile category, the aRR for postpartum infection was 1.64 (95% CI 1.46–1.84) in primiparous women, 2.43 (95% CI 1.98–2.98) in parous women with no previous caesarean delivery (CD) and 2.33 (95% CI 1.65–3.28) in parous women with a previous CD. The proportion mediated by second stage duration was 33.4% to 36.9% for the different outcomes in primiparous women. The risk of haematoma or ruptured sutures did not increased with a longer active first stage.ConclusionsIncreasing active first stage duration is associated with maternal complications in the early postpartum period.

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The Stockholm–Gotland perinatal cohort—A population‐based cohort including longitudinal data throughout pregnancy and the postpartum period

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 9 publications

References 44 publications

First stage of labour duration and associated risk of adverse neonatal outcomes

First stage of labour duration and associated risk of adverse neonatal outcomes

The data giveth, but what do we take away?

Duration of the active first stage of labour and severe perineal lacerations and maternal postpartum complications: a population‐based cohort study

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