Validation of disease registration in pregnant women in the Medical Birth Registry of Norway

Engeland, Anders; Bjørge, Tone; Daltveit, Anne Kjersti; Vollset, Stein Emil; Furu, Kari

doi:10.1080/00016340903128454

Cited by 45 publications

(65 citation statements)

References 22 publications

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“…Further, only amoxicillin is prescribed for urinary tract infections and only erythromycin or azithromycin for genital chlamydia. Confounding by underlying disease may also affect the results.The validity of asthma, diabetes and epilepsy registrations in the MBRN have been estimated to be 51%, 72%, and 74%, respectively [44]. We find that underlying maternal disease is more common among women who have been using antibiotics than among women who have not been using antibiotics.…”

Section: Advantages and Limitationsmentioning

confidence: 76%

Pregnancy outcome after gestational exposure to erythromycin – a population‐based register study from Norway

Romøren

Lindbæk

Nordeng

2012

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• It has generally been regarded as safe to take erythromycin during pregnancy. A recent study from Sweden found that erythromycin exposure in the first trimester was associated with congenital cardiovascular defects. The results led to warnings against using erythromycin in the first trimester from both the Swedish and Norwegian governments. WHAT THIS STUDY ADDS• This large, population-based register study did not find that erythromycin or macrolide use in pregnancy was significantly associated with congenital malformations, cardiovascular malformations or any other specific malformation. AIMSErythromycin is a macrolide antibiotic indicated for respiratory tract infections, genital chlamydia and skin infections. It has recently been suggested that erythromycin use in the first trimester of pregnancy can increase the risk of congenital cardiovascular malformations. This study aimed to determine whether erythromycin exposure in the first trimester is associated with cardiovascular or other malformations. METHODSWe studied 180 120 women in Norway who were pregnant during [2004][2005][2006][2007]. Data on all live births stillbirths and induced abortions after 12 gestational weeks from The Medical Birth Registry of Norway (MBRN) were linked to information from the Norwegian prescription database (NorPD). We compared the pregnancy outcomes of women who had taken erythromycin (n = 1786, 1.0%), penicillin V (n = 4921, 2.7%) or amoxicillin (n = 1599, 0.9%) in their first trimester with outcomes of women who had not taken any systemic antibiotics (n = 163 653, 90.9%) during this period. RESULTSThe risk of cardiovascular malformations was not significantly different with or without exposure to erythromycin in the first trimester (adjusted OR = 1.2 [95% CI 0.8, 1.8]) or in the most vulnerable period of heart formation (adjusted OR = 1.6 [95% CI 0.9-3.0]). Sub-analyses showed that the risk for any specific malformations was not increased with erythromycin, macrolides, penicillin V or amoxicillin compared with no antibiotic use in first trimester. CONCLUSIONSThis large, population-based register study did not find that exposure to erythromycin or macrolides in the first trimester of pregnancy was associated with fetal cardiovascular or other malformations. These results suggest that the risk of erythromycin use during early pregnancy, if any, is low.

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Section: Advantages and Limitationsmentioning

confidence: 76%

Pregnancy outcome after gestational exposure to erythromycin – a population‐based register study from Norway

Romøren

Lindbæk

Nordeng

2012

Brit J Clinical Pharma

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“…The sensitivity of the MBRN for epilepsy is reported to be 72% compared with records of patient utilization of prescribed anticonvulsants. 6 The incidence of birth defects was similar between the 2 birth groups, despite the statistical difference in epilepsy between them. Thus, in our limited data set, there was no evidence of an increased risk of birth defects in the offspring of patients with epilepsy and LGG.…”

Section: Discussionmentioning

confidence: 81%

“…This is further accentuated by the 72% sensitivity rate for the MBRN with regard to epilepsy as compared with records on patient use of anticonvulsants as detailed in the Norwegian prescription database. 6 However, other reports that include drug-specific information point out that there are more birth defects related to the use of valproic acid and phenobarbital. 18,28 Furthermore, they also point out that the teratogenic effect is not only related to the specific compound but also to the dosage used.…”

Section: Discussionmentioning

confidence: 99%

“…The quality of this registry has proven to be good. 6 The CRN database search was performed by selecting female individuals with brain tumors who were between the ages of 16 and 40 years at the time of their diagnosis during the time period from January 1, 1970, to December 31, 2008. Subsequently, these women were matched with records in the MBRN, and thus adding information about parity.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, the quality of these registries has been investigated and found to be good. 6,9 Another major study strength is our ability to identify a number of patients with LGG who subsequently gave birth. Our study includes 65 patients who gave birth after diagnosis and 281 patients who did not give birth after diagnosis.…”

Section: In a Retrospective Dutch Study Seizures In Patients Withmentioning

confidence: 99%

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The effect of pregnancy on survival in a low-grade glioma cohort

Rønning

Helseth

Meling

et al. 2016

JNS

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A dult low-grade gliomas (LGGs; World Health Organization [WHO] Grade II) are progressive brain tumors with diffuse borders against normal brain tissue and have a propensity to spread in an infiltrative manner throughout the brain. 16 These tumors demonstrate a tendency to evolve into more aggressive highgrade gliomas (HGGs). WHO Grade I tumors are also usually termed "LGG." However, the nature of these lesions is quite different from their Grade II counterpart in that the Grade I tumor is not infiltrative and usually demonstrates more compact growth characteristics, making it more amenable to complete resection.LGGs compose approximately 15% of all gliomas. 26 Patients most often present with seizures, but they can also demonstrate neurological and cognitive deficits or complain of headache.2,26 There is a clear tendency for patients with these tumors to present earlier in life than those with higher-grade tumors, with the median age at diagnosis being between 40 and 50 years. 11Therefore, female patients are often diagnosed with LGG while within their reproductive years. As clinicians, we are often questioned and expected to counsel female patients on the issue of how pregnancy and delivery affects the biology of their LGG and, ultimately, their own survival. To our knowledge, only 2 other reports detail the effects of pregnancy on patients with LGG. These reports originate from the French glioma study group and feature information on the clinical symptoms and speed of tumor growth in 11 patients and 12 pregnancies.19, 21 The results indicate that there is a peri-gestational increase in lesion growth rates witnessed on MR images. However, is it still unknown how this affects outcome and survival.Since patients often present with seizures, they are

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Validation of Danish registry‐cases of type 1 diabetes in women giving live birth using a clinical cohort as gold standard

Gundersen

Ebbehøj

Knorr

et al. 2022

Endocrino Diabet & Metabol

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Introduction The aim of this study was to validate type 1 diabetes in women giving live birth in the Danish national registries against a clinical cohort of confirmed cases (the Danish Diabetes Birth Registry [DDBR] cohort). Methods National registries including diagnosis codes, redeemed prescriptions and background data were combined. Three main algorithms were constructed to define type 1 diabetes in women giving live birth: (1) Any diabetes diagnosis registered before delivery and before age of 30, (2) a specific type 1 diabetes diagnosis registered before delivery regardless of maternal age and (3) a ‘preexisting type 1 diabetes in pregnancy’ diagnosis registered before delivery. In additional sub‐algorithms, we added information on anti‐diabetic medicine and gestational diabetes diagnosis. We calculated positive predictive value (PPV) and completeness using the DDBR cohort as gold standard. Since DDBR included between 75 and 93% of women with confirmed type 1 diabetes giving live birth, we used quantitative bias analysis to assess the potential impact of missing data on PPV and completeness. Results Main algorithm 2 had the highest PPV (77.4%) and shared the highest completeness (92.4%) with main algorithm 1. Information on anti‐diabetic medicine and gestational diabetes increased PPV, on expense of completeness. All algorithms varied with PPV between 65.7 and 87.6% and completeness between 73.6 and 92.4%. The quantitative bias analysis indicated that PPV was underestimated, and completeness overestimated for all algorithms. For algorithm 2, corrected PPV was between 82.1 and 94.6% and corrected completeness between 84.7 and 91.2%. Conclusions The Danish national registries can identify type 1 diabetes in women giving live birth with a reasonably high accuracy. The registries are a valuable source for future comparative outcome studies and may also be suitable for monitoring prevalence and incidence of type 1 diabetes in women giving live birth.

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Validation of disease registration in pregnant women in the Medical Birth Registry of Norway

Cited by 45 publications

References 22 publications

Pregnancy outcome after gestational exposure to erythromycin – a population‐based register study from Norway

Pregnancy outcome after gestational exposure to erythromycin – a population‐based register study from Norway

The effect of pregnancy on survival in a low-grade glioma cohort

Validation of Danish registry‐cases of type 1 diabetes in women giving live birth using a clinical cohort as gold standard

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