Background: The rate of preterm birth has been increasing worldwide. Most preterm babies are at an increased risk of central nervous system impairments as well as respiratory and gastrointestinal complications. The aim of this study was to investigate the epidemiologic characteristics of and associated factors contributing to preterm birth in Taiwan. Methods: Information on obstetric antecedents and risk factors for preterm birth in pregnant women was obtained from the National Health Insurance Research (NHIR) database provided by the Taiwan National Health Research Institute. All live births from 2004 to 2013 in Taiwan were included in this study. Results: A total of 130,362 live births from 2004 to 2013 were included in this study. Overall, the average annual rate of preterm births increased by 5.3% (from 3.33% in 2004 to 5.11% in 2013). Multiple logistic regression analyses showed that nulliparous women, multifetal pregnancies, advanced mother age, history of preterm birth, history of maternal drug abuse/dependence, and maternal medical complications were positively associated with an increased risk of preterm birth (all p-values< 0.05). Conclusion: The overall proportion of preterm births increased from 2004 to 2013 in Taiwan. Babies born preterm had a higher risk of developing morbidities and mortalities. The development of a comprehensive program to identify the high-risk group is needed for effective interventions to prevent premature birth.

Postmenopausal women with hepatitis B virus (HBV) infection are more likely to have accelerated liver fibrosis, eventually advancing to liver cirrhosis or hepatocellular carcinoma (HCC). The association between sex hormones and HBV-related HCC risk is unclear. We investigated whether hormone replacement therapy (HRT) is beneficial to postmenopausal women with HBV infection. This retrospective study selected the data of 44,465patients with HBV infection between January 2000 and December 2018 from Taiwan’s National Health Insurance Research Database. After excluding patients with preexisting liver diseases, liver cirrhosis, or liver malignancies, we grouped the remaining 10,474 patients by whether they had undergone HRT for at least 3 months (n = 5,638) and whether they had not received HRT (n = 4,836). After propensity score matching, we assigned 3080 patients to an HRT cohort and matched them (1:1) with those in a non-HRT cohort. The incidence of HCC (P < 0.022) and all-cause mortality rate (P < 0.001) were lower in the HRT cohort than in the non-HRT cohort. The liver cirrhosis risk was not significantly higher in the HRT cohort (P = 0.355). HRT is associated with reduced HCC risk and improved survival outcomes but is unrelated to liver cirrhosis development in postmenopausal women.

This retrospective cohort study evaluated the effects of different frequencies of physical therapy intervention on the total knee arthroplasty (TKA) and total hip arthroplasty (THA) risk of osteoarthritis (OA) patients. We sampled 438,833 insurants from Taiwan National Health Insurance Research Database for patients diagnosed as having OA during 2000 to 2013. OA who received physical therapy within in the first year of OA diagnosis were divided based on the number of sessions they received in that first year: >24, 13–23, and 24 cohort and 4.9% and 1.4% (all P < .001) in the comparison cohort. Moreover, the HRs of TKA and THA in the >24 cohort were 0.77 (0.67–0.87, P < .001) and 0.71 (0.53–0.96, P = .024), respectively. By contrast, no significant differences were noted between the 13–23 and 24 physical therapy sessions within 1 year of receiving an OA diagnosis exhibited reduced of TKA and THA risks.

This study aimed to investigate the occurrence and risk factors of thyroid dysfunction (TD) in patients with chronic hepatitis C (CHC) infection in Taiwan. The data in this study were obtained from the Taiwan National Health Insurance Research (Taiwan NHIR) database between 2001 and 2013. CHC patients treated with pegylated interferon/ribavirin (PEG-IFN/RBV) were enrolled as case patients, and nontreated CHC patients were enrolled as controls and were matched at a control:case ratio of 3:1 by index date, age (± 3 years), and sex. We compared the cumulative incidence of TD between the cohorts at follow-up until 2013. During the study period, 3810 cases and 9393 controls were included in the study. Among the study subjects, 173 (4.5%) case patients and 244 (2.6%) controls were diagnosed with TD during the follow-up period. The types of TD were hypothyroidism (42.9%), hyperthyroidism (31.2%), and thyroiditis (25.9%). Compared to controls during the 13-year follow-up, patients treated with PEG-IFN/RBV had a higher incidence rate of TD (P < 0.0001), as determined using the Kaplan-Meier method. Cox proportional hazards regression analysis showed that female sex (adjusted hazard ratio (HR): 1.49; 95% confidence interval (CI): 1.23–1.75; P < 0.001), treatment with PEG-IFN/RBV (HR: 1.68; 95% CI: 1.38–2.06; P < 0.001), hyperlipidemia (HR: 1.38; 95% CI: 1.12–1.71; P < 0.001), and past history of goiter (HR: 6.40; 95% CI: 5.00–8.18; P < 0.001) were independent predictors for the development of TD. PEG-IFN/RBV treatment may be an independent risk factor for thyroid dysfunction among patients with hepatitis C virus (HCV) infection. Monitoring thyroid function keenly during PEG-IFN/RBV therapy in patients with chronic HCV infection is recommended for clinicians, especially for female patients and for patients with a history of hyperlipidemia and goiter.

The aim of this study was to quantitatively estimate the long-term risk of abortion-related consequences and comorbidities. We identified 36,375 patients with at least 2 diagnosed abortions from 2000 to 2013 and included them in the abortion group. This group was further subdivided into 4 subgroups: spontaneous abortion, induced abortion, nonspecific abortion, and mixed-type abortion groups. For comparison, another 36,375 pregnant women from the National Health Insurance Research Database of Taiwan were included in the nonabortion group. For the puerperal cohort, the index year was defined as the year with the occurrence of at least 1 pregnancy. The puerperal cohort was then matched to the abortion cohort by age; comorbidities of diabetes mellitus, hypertension, and hyperlipidemia; and index year at a 1:1 ratio. The data of these cohorts were used to examine the risk of abortion-related consequences and comorbidities in pregnant women after a mean follow-up period of 7.60 person-years. The spontaneous abortion group exhibited significantly elevated adjusted hazard ratios (HRs) of 1.493 for pelvic inflammatory disease (P < .001), 1.680 for urinary tract infection (P < .001), 3.771 for ectopic pregnancy (P < .001), and 1.938 for infertility with no subsequent conception (P < .001). However, this group exhibited statistically insignificant HRs of 1.709 for placenta previa (P = .260), 2.982 for placenta abruption (P = .344), 1.499 for incompetent cervix (P = .658), and 0.854 for early onset of labor (P = .624). The induced abortion group showed a statistically significant elevated adjusted HR of 1.291 for urinary tract infection (P = .008) but statistically insignificant HRs of 1.031 for pelvic inflammatory disease, 1.637 for ectopic pregnancy, 5.114 for placenta previa, 65.434 for placenta abruption, 0.998 for incompetent cervix, 0.285 for early onset of labor, and 1.019 for subsequent infertility with no subsequent conception. Clinicians encountering patients in a predicament such as spontaneous or induced abortion should unprejudicely and objectively inform the patients of the effects or influence of abortion on their physical health, including statistically significant and insignificant risks. Induced abortion may not be an independent risk factor for subsequent infertility.