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Using fathers as a negative control exposure to test the Developmental Origins of Health and Disease Hypothesis: A case study on maternal distress and offspring asthma using Swedish register data
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
Örebro University, School of Medical Sciences. Karolinska Inst, Dept Med Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden& Biostat, POB 281, SE-17177 Stockholm, Sweden.;Orebro Univ, Sch Med Sci, Orebro, Sweden..ORCID iD: 0000-0002-6851-3297
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2017 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 17, 36-40 p.Article in journal (Refereed) Published
Abstract [en]

Background: Developmental Origins of Health and Disease Hypothesis (DOHaD) studies are often observational in nature and are therefore prone to biases from loss to follow-up and unmeasured confounding. Register-based studies can reduce these issues since they allow almost complete follow-up and provide information on fathers that can be used in a negative control analysis to assess the impact of unmeasured confounding.

Aim: The aim of this study was to propose a causal model for testing DOHaD using paternal exposure as a negative control, and its application to maternal distress in pregnancy and offspring asthma.

Methods: A causal diagram including shared and parent-specific measured and unmeasured confounders for maternal (fetal) and paternal exposures is proposed. The case study consisted of all children born in Sweden from July 2006 to December 2008 (n=254,150). Information about childhood asthma, parental distress and covariates was obtained from the Swedish national health registers. Associations between maternal and paternal distress during pregnancy and offspring asthma at age five years were assessed separately and with mutual adjustment for the other parent's distress measure, as well as for shared confounders.

Results: Maternal distress during pregnancy was associated with offspring asthma risk; mutually adjusted odds ratio (OR) (OR 1.32, 95% CI 1.23, 1.43). The mutually adjusted paternal distress-offspring asthma analysis (OR 1.05, 95% CI 0.97, 1.13) indicated no evidence for unmeasured confounding shared by the mother and father.

Conclusions: Using paternal exposure in a negative control model to test the robustness of fetal programming hypotheses can be a relatively simple extension of conventional observational studies but limitations need to be considered.

Place, publisher, year, edition, pages
Sage Publications, 2017. Vol. 45, no 17, 36-40 p.
Keyword [en]
Negative control, epidemiology, fetal programming, Developmental Origins of Health and Disease Hypothesis, asthma, maternal distress
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:oru:diva-59315DOI: 10.1177/1403494817702324ISI: 000405007800007PubMedID: 28683663Scopus ID: 2-s2.0-85022229503OAI: oai:DiVA.org:oru-59315DiVA: diva2:1136071
Funder
Swedish Heart Lung FoundationSwedish Asthma and Allergy AssociationForte, Swedish Research Council for Health, Working Life and Welfare
Note

Funding Agencies:

Swedish Research Council through the Swedish Initiative for research on Microdata in the Social And Medical sciences (SIMSAM)  340-2013-5867

Stockholm County Council (ALF project)

Commission under a COFAS Marie Curie Fellowship  

European Union  634821 

Available from: 2017-08-25 Created: 2017-08-25 Last updated: 2017-10-18Bibliographically approved

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CiteExportLink to record
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