Publications by authors named "Harriet Forbes"
Article Synopsis
- The study investigates how using antidepressants during pregnancy impacts various birth outcomes, including stillbirth and preterm delivery.
- It analyzed data from over 2.5 million births across the UK and Scandinavia, discovering that 4.8% of deliveries involved mothers who used antidepressants.
- Results indicate a slight increase in risks for negative outcomes like stillbirth and low Apgar scores linked to maternal antidepressant use, but these risks remained low overall and might be influenced by underlying mental health conditions.
The teratogenic potential of valproate in pregnancy is well established; however, evidence regarding the long-term safety of other antiseizure medications (ASMs) during pregnancy remains limited. Using routinely collected primary care data from the UK and nationwide Swedish registries to create a cohort of 3,182,773 children, of which 17,495 were exposed to ASMs in pregnancy, we show that those exposed to valproate were more likely to receive a diagnosis of autism, intellectual disability, and ADHD, when compared to children not exposed to ASMs. Additionally, children exposed to topiramate were 2.
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- The study explored the connection between depression, anxiety, and alcohol use disorder (AUD) in individuals diagnosed with Type 2 diabetes mellitus (T2DM) within an English primary care population.
- Researchers analyzed data from nearly 480,000 people diagnosed with T2DM from 2004 to 2019 to see how these mental health conditions occur in those with and without prior AUD.
- Results indicated that individuals with AUD were significantly more likely to experience new episodes of depression and anxiety after their T2DM diagnosis compared to those without AUD, even after adjusting for various confounding factors.
Background: Psychiatric comorbidities are common in patients with epilepsy. Reasons for the co-occurrence of psychiatric conditions and epilepsy remain poorly understood.
Aim: We aimed to triangulate the relationship between epilepsy and psychiatric conditions to determine the extent and possible origins of these conditions.
Importance: Associations have been found between COVID-19 and subsequent mental illness in both hospital- and population-based studies. However, evidence regarding which mental illnesses are associated with COVID-19 by vaccination status in these populations is limited.
Objective: To determine which mental illnesses are associated with diagnosed COVID-19 by vaccination status in both hospitalized patients and the general population.
Background: Some studies have shown that the incidence of type 2 diabetes increases after a diagnosis of COVID-19, although the evidence is not conclusive. However, the effects of the COVID-19 vaccine on this association, or the effect on other diabetes subtypes, are not clear. We aimed to investigate the association between COVID-19 and incidence of type 2, type 1, gestational and non-specific diabetes, and the effect of COVID- 19 vaccination, up to 52 weeks after diagnosis.
View Article and Find Full Text PDFBackground: Antiseizure medications (ASMs) during the first trimester of pregnancy have been associated with an increased risk of miscarriage.
Methods: We carried out a population-based cohort study using routinely collected healthcare data from the UK, 1995-2018. Pregnancies were identified in the Clinical Practice Research Datalink and we estimated the HR of miscarriage associated with prescriptions of ASMs during the first trimester of pregnancy, using Cox regression, adjusting for potential confounders, including ASM indications.
Infection with SARS-CoV-2 is associated with an increased risk of arterial and venous thrombotic events, but the implications of vaccination for this increased risk are uncertain. With the approval of NHS England, we quantified associations between COVID-19 diagnosis and cardiovascular diseases in different vaccination and variant eras using linked electronic health records for ~40% of the English population. We defined a 'pre-vaccination' cohort (18,210,937 people) in the wild-type/Alpha variant eras (January 2020-June 2021), and 'vaccinated' and 'unvaccinated' cohorts (13,572,399 and 3,161,485 people respectively) in the Delta variant era (June-December 2021).
View Article and Find Full Text PDFBackground: A history of multiple myeloma, prostate cancer, and breast cancer has been associated with adverse bone health, but associations across a broader range of cancers are unclear. We aimed to compare the risk of any bone fracture and major osteoporotic fractures in survivors of a wide range of cancers versus cancer-free individuals.
Methods: In this population-based matched cohort study, we used electronic health records from the UK Clinical Practice Research Datalink linked to hospital data.
Background: Literature surrounding the association between antidepressant use during pregnancy and miscarriage is conflicting. We aimed to conduct a systematic review and meta-analysis of studies among pregnant women regarding the association between exposure to antidepressants during pregnancy and the risk of miscarriage, compared with pregnant women not exposed to antidepressants.
Design: We conducted a systematic review and meta-analysis of non-randomised studies.
Objective: To examine antiseizure medication (ASM) prescription during pregnancy.
Design: Population-based drug utilisation study.
Setting: UK primary and secondary care data, 1995-2018, from the Clinical Practice Research Datalink GOLD version.
Background: Lymphocyte skin homing in atopic eczema (AE) may induce lymphopenia.
Objective: To determine if AE is associated with lymphopenia.
Methods: We used UK primary care electronic health records (Clinical Practice Research Datalink GOLD) for a matched cohort study in adults (18 years+) (1997-2015) with at least one recorded lymphocyte count.
Article Synopsis
- The study investigates the relationship between influenza vaccination and the incidence of first myocardial infarctions and strokes, particularly focusing on how different levels of cardiovascular risk influence this association.
- It utilized extensive health data from England over 11 years to analyze the occurrence of acute cardiovascular events in individuals aged 40-84 shortly after receiving the vaccine.
- The findings indicate that the risk of cardiovascular events significantly decreases in the weeks following vaccination, suggesting that the flu shot may have protective cardiovascular benefits for individuals across various risk levels, although more research is needed to identify which populations could benefit the most.
Background: Ethnic differences in the risk of severe COVID-19 may be linked to household composition. We quantified the association between household composition and risk of severe COVID-19 by ethnicity for older individuals.
Methods: With the approval of NHS England, we analysed ethnic differences in the association between household composition and severe COVID-19 in people aged 67 or over in England.
Objective: To compare the effectiveness of the BNT162b2 mRNA (Pfizer-BioNTech) and the ChAdOx1 (Oxford-AstraZeneca) covid-19 vaccines against infection and covid-19 disease in health and social care workers.
Design: Cohort study, emulating a comparative effectiveness trial, on behalf of NHS England.
Setting: Linked primary care, hospital, and covid-19 surveillance records available within the OpenSAFELY-TPP research platform, covering a period when the SARS-CoV-2 Alpha variant was dominant.
Objectives: To investigate the association between mode of delivery and subsequent maternal sexual wellbeing.
Design: Prospective birth cohort study.
Setting: Avon (in Bristol area), UK.
Background: While the vaccines against COVID-19 are highly effective, COVID-19 vaccine breakthrough is possible despite being fully vaccinated. With SARS-CoV-2 variants still circulating, describing the characteristics of individuals who have experienced COVID-19 vaccine breakthroughs could be hugely important in helping to determine who may be at greatest risk.
Methods: With the approval of NHS England, we conducted a retrospective cohort study using routine clinical data from the OpenSAFELY-TPP database of fully vaccinated individuals, linked to secondary care and death registry data and described the characteristics of those experiencing COVID-19 vaccine breakthroughs.
Background: The risk of severe COVID-19 outcomes in people with immune-mediated inflammatory diseases and on immune-modifying drugs might not be fully mediated by comorbidities and might vary by factors such as ethnicity. We aimed to assess the risk of severe COVID-19 in adults with immune-mediated inflammatory diseases and in those on immune-modifying therapies.
Methods: We did a cohort study, using OpenSAFELY (an analytics platform for electronic health records) and TPP (a software provider for general practitioners), analysing routinely collected primary care data linked to hospital admission, death, and previously unavailable hospital prescription data.
At the outset of the COVID-19 pandemic, there was no routine comprehensive hospital medicines data from the UK available to researchers. These records can be important for many analyses including the effect of certain medicines on the risk of severe COVID-19 outcomes. With the approval of NHS England, we set out to obtain data on one specific group of medicines, "high-cost drugs" (HCD) which are typically specialist medicines for the management of long-term conditions, prescribed by hospitals to patients.
View Article and Find Full Text PDFPatients surviving hospitalisation for COVID-19 are thought to be at high risk of cardiometabolic and pulmonary complications, but quantification of that risk is limited. We aimed to describe the overall burden of these complications in people after discharge from hospital with COVID-19. Working on behalf of NHS England, we used linked primary care records, death certificate and hospital data from the OpenSAFELY platform.
View Article and Find Full Text PDFBackground: Early evidence has shown that anticoagulant reduces the risk of thrombotic events in those infected with COVID-19. However, evidence of the role of routinely prescribed oral anticoagulants (OACs) in COVID-19 outcomes is limited.
Aim: To investigate the association between OACs and COVID-19 outcomes in those with atrial fibrillation and a CHADS-VASc score of 2.
Comparison of methods for predicting COVID-19-related death in the general population using the OpenSAFELY platform.
Diagn Progn Res
February 2022
Background: Obtaining accurate estimates of the risk of COVID-19-related death in the general population is challenging in the context of changing levels of circulating infection.
Methods: We propose a modelling approach to predict 28-day COVID-19-related death which explicitly accounts for COVID-19 infection prevalence using a series of sub-studies from new landmark times incorporating time-updating proxy measures of COVID-19 infection prevalence. This was compared with an approach ignoring infection prevalence.
Background: Residents in care homes have been severely impacted by COVID-19. We describe trends in the mortality risk among residents of care homes compared to private homes.
Methods: On behalf of NHS England we used OpenSAFELY-TPP to calculate monthly age-standardised risks of death due to all causes and COVID-19 among adults aged >=65 years between 1/2/2019 and 31/03/2021.