Live birth prevalence of hemolytic disease of the fetus and newborn in the United States from 1996 to 2010

YU, Devin; LING, Leona E.; KRUMME, Alexis A.; TJOA, May Lee; MOISE, Kenneth J.

doi:10.1016/j.xagr.2023.100203

“…They cite an Rh-related sensitization risk of 1.6 per 1000 pregnancies, although their reference states that “Rh-induced HDFN live birth prevalence rates ranged from 44.4 to 98.7 per 100 000 births,” or less than 1 per 1000. This is consistent with the population sensitization rate following introduction of Rh immunoglobulin administration at 28 weeks’ gestation, but not earlier in pregnancy . Other causes of sensitization not prevented by Rh immunoglobulin explain some of the difference.…”

supporting

confidence: 83%

Rh Sensitization and Induced Abortion—Reply

Horvath,

Schreiber,

Luning Prak

2024

JAMA

0

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In Reply We thank Dr Hecht for his comment on our recent research article examining sedentary behavior and incident dementia. 1 We agree that the possibility of ascertainment bias is an important issue that warrants careful consideration. As we discussed in the Limitations section of our article, 1 the use of hospital records and death registry data for dementia diagnoses may provide less accurate diagnoses or may underestimate cases in this cohort, leading to the potential for ascertainment bias related to links between physical activity and overall health. To help address this limitation, we included presence of chronic disease (cardiovascular disease, cancer, or diabetes) as well as self-reported general health in our fully adjusted models to account for health conditions other than dementia in this sample. 1 To further determine whether the likelihood of hospitalization or death impacts our results, we have now included the number of hospitalizations after the start of follow-up, as well as death events, as additional covariates in our fully adjusted model. Inclusion of these covariates did not substantially affect our results showing that sedentary behavior has a nonlinear association with incident dementia; however, the hazard ratios for dementia were somewhat attenuated. In a model including these new covariates, hazard ratios for dementia relative to median sedentary behavior (9.27 hours per day) were 1.06 (95% CI, 1.02-1.10; P < .01) for 10 hours per day, 1.46 (95% CI, 1.22-1.76; P < .001) for 12 hours per day, and 2.51 (95% CI, 1.61-3.92; P < .001) for 15 hours per day. In a second analysis, we restricted our sample to only individuals with a hospital record or who died during follow-up. Again, results were similar to our original findings: hazard ratios for dementia relative to median sedentary behavior (9.27 hours per day) were 1.06 (95% CI, 1.01-1.11; P = .03) for 10 hours per day, 1.40 (95% CI, 1.08-1.80; P = .01) for 12 hours per day, and 2.21 (95% CI, 1.20-4.08; P = .01) for 15 hours per day. While these analyses cannot fully rule out the possibility of ascertainment bias, we believe our original results controlling for health status, combined with these new analyses controlling for hospitalizations and death, further support our overall finding that engaging in large amounts of sedentary behavior is associated with greater risk of dementia. Future work that can include other sources of information for dementia diagnoses will allow us to further test the association between sedentary behavior and all-cause dementia.

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“…To the Editor Rh immunoglobulin use by Rh-negative pregnant individuals reduces the risk of HDFN—having saved hundreds of thousands of lives and preserved the reproductive capacities of millions of individuals . HDFN, including due to Rh sensitization, still remains a public health issue, with an estimated incidence of 1.6 per 1000 live births . As reported in 1970, the immunization risk among pregnant individuals with prior abortions directly correlated with gestational age, increasing from the first to the third month of gestation and was observed in 2.8% (26/932) of these individuals .…”

mentioning

confidence: 98%

Rh Sensitization and Induced Abortion

Galen,

Kaufman,

Evans

2024

JAMA

0

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In Reply We thank Dr Hecht for his comment on our recent research article examining sedentary behavior and incident dementia. 1 We agree that the possibility of ascertainment bias is an important issue that warrants careful consideration. As we discussed in the Limitations section of our article, 1 the use of hospital records and death registry data for dementia diagnoses may provide less accurate diagnoses or may underestimate cases in this cohort, leading to the potential for ascertainment bias related to links between physical activity and overall health. To help address this limitation, we included presence of chronic disease (cardiovascular disease, cancer, or diabetes) as well as self-reported general health in our fully adjusted models to account for health conditions other than dementia in this sample. 1 To further determine whether the likelihood of hospitalization or death impacts our results, we have now included the number of hospitalizations after the start of follow-up, as well as death events, as additional covariates in our fully adjusted model. Inclusion of these covariates did not substantially affect our results showing that sedentary behavior has a nonlinear association with incident dementia; however, the hazard ratios for dementia were somewhat attenuated. In a model including these new covariates, hazard ratios for dementia relative to median sedentary behavior (9.27 hours per day) were 1.06 (95% CI, 1.02-1.10; P < .01) for 10 hours per day, 1.46 (95% CI, 1.22-1.76; P < .001) for 12 hours per day, and 2.51 (95% CI, 1.61-3.92; P < .001) for 15 hours per day. In a second analysis, we restricted our sample to only individuals with a hospital record or who died during follow-up. Again, results were similar to our original findings: hazard ratios for dementia relative to median sedentary behavior (9.27 hours per day) were 1.06 (95% CI, 1.01-1.11; P = .03) for 10 hours per day, 1.40 (95% CI, 1.08-1.80; P = .01) for 12 hours per day, and 2.21 (95% CI, 1.20-4.08; P = .01) for 15 hours per day. While these analyses cannot fully rule out the possibility of ascertainment bias, we believe our original results controlling for health status, combined with these new analyses controlling for hospitalizations and death, further support our overall finding that engaging in large amounts of sedentary behavior is associated with greater risk of dementia. Future work that can include other sources of information for dementia diagnoses will allow us to further test the association between sedentary behavior and all-cause dementia.

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“…This raises concerns about the reliability of gestational age as an indicator for Rh immunoglobulin administration unless ultrasonography is provided for all of these individuals. Unfortunately, HDFN is not uncommon, affecting approximately 1.6 per 1000 pregnancies, and prevention through administration of Rh immunoglobulin remains the most effective treatment option. Any decision to forgo treatment that has demonstrated efficacy in preventing HDFN should be supported by studies with compelling medical outcomes.…”

mentioning

confidence: 99%

Rh Sensitization and Induced Abortion

Moise,

Abels

2024

JAMA

Self Cite

0

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In Reply We thank Dr Hecht for his comment on our recent research article examining sedentary behavior and incident dementia. 1 We agree that the possibility of ascertainment bias is an important issue that warrants careful consideration. As we discussed in the Limitations section of our article, 1 the use of hospital records and death registry data for dementia diagnoses may provide less accurate diagnoses or may underestimate cases in this cohort, leading to the potential for ascertainment bias related to links between physical activity and overall health. To help address this limitation, we included presence of chronic disease (cardiovascular disease, cancer, or diabetes) as well as self-reported general health in our fully adjusted models to account for health conditions other than dementia in this sample. 1 To further determine whether the likelihood of hospitalization or death impacts our results, we have now included the number of hospitalizations after the start of follow-up, as well as death events, as additional covariates in our fully adjusted model. Inclusion of these covariates did not substantially affect our results showing that sedentary behavior has a nonlinear association with incident dementia; however, the hazard ratios for dementia were somewhat attenuated. In a model including these new covariates, hazard ratios for dementia relative to median sedentary behavior (9.27 hours per day) were 1.06 (95% CI, 1.02-1.10; P < .01) for 10 hours per day, 1.46 (95% CI, 1.22-1.76; P < .001) for 12 hours per day, and 2.51 (95% CI, 1.61-3.92; P < .001) for 15 hours per day. In a second analysis, we restricted our sample to only individuals with a hospital record or who died during follow-up. Again, results were similar to our original findings: hazard ratios for dementia relative to median sedentary behavior (9.27 hours per day) were 1.06 (95% CI, 1.01-1.11; P = .03) for 10 hours per day, 1.40 (95% CI, 1.08-1.80; P = .01) for 12 hours per day, and 2.21 (95% CI, 1.20-4.08; P = .01) for 15 hours per day. While these analyses cannot fully rule out the possibility of ascertainment bias, we believe our original results controlling for health status, combined with these new analyses controlling for hospitalizations and death, further support our overall finding that engaging in large amounts of sedentary behavior is associated with greater risk of dementia. Future work that can include other sources of information for dementia diagnoses will allow us to further test the association between sedentary behavior and all-cause dementia.

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Live birth prevalence of hemolytic disease of the fetus and newborn in the United States from 1996 to 2010

Cited by 20 publications

References 28 publications

Rh Sensitization and Induced Abortion—Reply

Rh Sensitization and Induced Abortion—Reply

Rh Sensitization and Induced Abortion

Rh Sensitization and Induced Abortion

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