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Original Articles
Does the father’s job matter? Parental occupation and preterm birth in Korea
Taemi Kim, Eunseon Gwak, Bolormaa Erdenetuya, Jeong-Won Oh, Jung-won Yoon, Myoung-Hee Kim, Jia Ryu, Seung-Ah Choe
Epidemiol Health. 2023;45:e2023078.   Published online August 24, 2023
DOI: https://doi.org/10.4178/epih.e2023078
  • 3,221 View
  • 97 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Limited evidence is available regarding the impact of paternal occupation and its combined effect with maternal occupation on preterm birth. Therefore, we assessed the association of maternal and paternal occupations with preterm birth.
METHODS
We used the national birth data of Korea between 2010 and 2020. Parental occupations were divided into 5 categories: (1) managers; (2) professionals, technicians, and related workers; (3) clerks and support workers; (4) service and sales workers; and (5) manual workers. A multinomial logistic regression model was used to calculate the adjusted odds ratios (aORs) of extremely, very, and moderate-to-late preterm births per occupational category considering individual risk factors.
RESULTS
For the 4,004,976 singleton births, 40.2% of mothers and 95.5% of fathers were employed. Compared to non-employment, employment was associated with a lower risk of preterm birth. Among employed mothers, service and sales occupations were associated with a higher risk of preterm birth than managerial occupations (aOR, 1.06; 95% confidence interval [CI], 1.01 to 1.10 for moderate-to-late preterm births). The father’s manual occupation was associated with a higher risk of preterm birth (aOR, 1.09; 95% CI, 1.05 to 1.13 for moderate-to-late preterm) than managerial occupations. When both parents had high-risk occupations, the risk of preterm birth was higher than in cases where only the mother or neither of the parents had a high-risk occupation.
CONCLUSIONS
Paternal occupation was associated with preterm birth regardless of maternal employment and occupation and modified the effect of maternal occupation. Detailed occupational environment data are needed to identify the paternal exposures that increase the risk.
Summary
Korean summary
본 연구는 2010년부터 2020년까지 출생신고자료를 활용하여 부모의 직업이 조산에 미치는 영향에 대해 살펴보았다. 어머니의 경우 서비스 및 판매직종에서 근무할 경우 관리자 직종에 비해 조산 위험이 높았고, 아버지의 경우 육체노동자일 경우 조산의 위험이 높아졌다. 특히 부모 모두 고위험 직업을 가질수록 한쪽만 고위험 직업을 가졌을 때보다 조산 위험이 더 높았다.
Key Message
This study explored the association between parental occupation and preterm birth using Korean national birth data from 2010 to 2020. The analysis revealed that employment was associated with a lower preterm birth risk. Among employed mothers, service and sales occupations exhibited a higher risk than managerial occupations and paternal manual occupations were associated with increased preterm birth risk. When both parents were employed in high-risk occupations, the probability of preterm birth was greater compared to cases where only one of them had such an occupation.
Impaired pulmonary function mediates the impact of preterm birth on later-life stroke: a 2-step, multivariable Mendelian randomization study
Xingzhi Guo, Peng Tang, Chen Hou, Yue Liu, Rui Li
Epidemiol Health. 2023;45:e2023031.   Published online March 3, 2023
DOI: https://doi.org/10.4178/epih.e2023031
  • 4,769 View
  • 193 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Observational studies have suggested an association between preterm birth and stroke in late adulthood, but it remains unclear whether the association is causal. The purpose of this study was to evaluate the causal effects of gestational age on stroke and to determine the pathophysiological mechanisms underlying the causal associations.
METHODS
Two-sample Mendelian randomization (MR) was performed to assess the causal effects of fetal gestational duration, early preterm birth (EPB), preterm birth, or postterm birth on stroke and its subtypes. Two-step Mendelian randomization (TSMR) and multivariable Mendelian randomization (MVMR) were additionally used to determine the role of common stroke risk factors, including cardiovascular diseases, hypertension, pulmonary impairment, inflammation, and metabolic diseases, in mediating the causal associations between gestational age and stroke and its subtypes.
RESULTS
Genetically predicted EPB increased the risk of cardioembolic stroke (CES; odds ratio [OR], 1.115; 95% confidence interval [CI], 1.036 to 1.200; p=0.004) and large artery stroke (LAS; OR, 1.131; 95% CI, 1.031 to 1.241; p=0.009). The TSMR results showed that EPB was associated with a lower forced expiratory volume in the first second and forced vital capacity ratio (FEV1/FVC) (β=-0.020; 95% CI, -0.035 to -0.005; p=0.009), which increased the risk of CES and LAS. Further MVMR analysis showed that the associations between EPB and stroke disappeared after adjustment for FEV1/FVC.
CONCLUSIONS
Our data demonstrate that EPB is causally associated with an elevated risk of CES and LAS, and that pulmonary dysfunction mediates the causal impact of EPB on CES and LAS.
Summary
Key Message
Genetically predicted early preterm birth (EPB) is significantly associated with an increased risk of cardioembolic stroke (CES) and large artery stroke (LAS). Further multivariable Mendelian randomization analysis demonstrates that pulmonary impairment mediates the causal impact of EPB on CES and LAS in adulthood.

Citations

Citations to this article as recorded by  
  • Causal associations of circulating Helicobacter pylori antibodies with stroke and the mediating role of inflammation
    Xingzhi Guo, Peng Tang, Xin Zhang, Rui Li
    Inflammation Research.2023; 72(6): 1193.     CrossRef
  • Methodological approaches, challenges, and opportunities in the application of Mendelian randomisation to lifecourse epidemiology: A systematic literature review
    Grace M. Power, Eleanor Sanderson, Panagiota Pagoni, Abigail Fraser, Tim Morris, Claire Prince, Timothy M. Frayling, Jon Heron, Tom G. Richardson, Rebecca Richmond, Jessica Tyrrell, Nicole Warrington, George Davey Smith, Laura D. Howe, Kate M. Tilling
    European Journal of Epidemiology.2023;[Epub]     CrossRef
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