Bronwyn K Brew

UNSW Sydney | UNSW · Centre for Big Data in Health Research

Brew BK, Allen CW, Toelle BG, Marks GB. Systematic review and meta-analysis investigating breast feeding and childhood wheezing illness. Paediatric and Perinatal Epidemiology 2011; 25: 507–518. There is conflicting evidence concerning the relationship between breast feeding and wheezing illness. The objective of this study was to investigate whethe...

Background Children with asthma and atopic diseases have an increased risk of depression or anxiety. Each of these diseases has strong genetic and environmental components; therefore, it seems likely that there is a shared liability rather than causative risk. Objective To investigate the existence and nature of familial aggregation for the comorb...

Background: Prenatal maternal stress may influence offspring's atopic risk through sustained cortisol secretion resulting from activation of the hypothalamic-pituitary-axis (HPA), leading to Th2-biased cell differentiation in the fetus. We undertook a systematic review and meta-analysis investigating the relationship between prenatal maternal psyc...

Background: Previous research has found that maternal stress during pregnancy increases the risk of offspring asthma. However, whether this association is consistent with a causal interpretation has never been tested. The objective is to determine whether there is a critical exposure period for maternal depression or anxiety on offspring asthma or...

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...

Landscape fires are increasing in frequency and severity globally. In Australia, extreme bushfires cause a large and increasing health and socioeconomic burden for communities and governments. People with asthma are particularly vulnerable to the effects of landscape fire smoke (LFS) exposure. Here, we present a position statement from the Thoracic...

Study question: Does a public online IVF success prediction calculator based on real-world data help set patient expectations? Summary answer: The YourIVFSuccess Estimator aided consumer expectations of IVF success: one quarter (24%) of participants were unsure of their estimated IVF success before using the tool; one half changed their predicti...

Background: Hypertensive Disorders of Pregnancy (HDP) complicate 5-10% of pregnancies globally: 2-5% preeclampsia, 3% gestational hypertension, and 0.5-2% chronic hypertension. It is epidemiologically well established that adverse health effects of HDP do not end with the pregnancy: these conditions are associated with increased lifetime cardiovasc...

Introduction: To investigate the association between maternal depression/anxiety during pregnancy and offspring type 1 diabetes, to assess the specific importance of exposure during pregnancy by comparing across different exposure periods before and/or after pregnancy, and to explore potential unmeasured familial confounding. Research design and...

Motivation: Directed acyclic graphs (DAGs) are used in epidemiological research to communicate causal assumptions and guide the selection of covariate adjustment sets when estimating causal effects. For any given DAG, a set of graphical rules can be applied to identify minimally sufficient adjustment sets that can be used to adjust for bias due to...

Background: Atopic dermatitis is a common chronic childhood disease associated with significant morbidity and healthcare costs. There is a known association between caesarean section and asthma, but the relationship between caesarean section and offspring atopic dermatitis remains uncertain. Methods: We conducted a register-based nationwide coho...

Objective: To assess the association between maternal asthma and adverse perinatal outcomes in an Australian Indigenous population. Methods: This prospective cohort study included all Indigenous mother and baby dyads for births from 2001 to 2013 in Western Australia (n = 25 484). Data were linked from Western Australia Births, Deaths, Midwives,...

It is increasingly recognised that children with asthma are at a higher risk of other non‐allergic concurrent diseases than the non‐asthma population. A plethora of recent research has reported on these comorbidities and progress has been made into understanding the mechanisms for comorbidity. The goal of this review was to assess the most recent e...

Background: Although severe acute COVID-19 is rare in children, SARS-CoV-2 infection can trigger the novel post-infectious condition multisystem inflammatory syndrome in children (MIS-C). Increased knowledge on risk factors for MIS-C could improve our understanding of the pathogenesis of the condition and better guide targeted public health interv...

Background From November 2019 to January 2020, eastern Australia experienced the worst bushfires in recorded history. Two months later, Sydney and surrounds were placed into lockdown for six weeks due to the COVID-19 pandemic, followed by ongoing restrictions. Many pregnant women at this time were exposed to both the bushfires and COVID-19 restrict...

Research has shown a link between gender, violence, and suicide. This relationship is complex, and few empirical studies have explored suicide and family and interpersonal violence perpetrated by men. Drawing on a coronial dataset of suicide cases and a mixed methods design, this study integrated a quantitative analysis of 155 suicide cases with a...

Introduction: Gastroesophageal reflux disease (GERD) is the most common non-allergic comorbidity in adults with asthma, however comorbidity with other atopic diseases such as eczema and hayfever is unclear. The objective was to assess the comorbidity of GERD with asthma and atopic diseases, and to investigate possible mechanisms, including genetic...

(Abstracted from Ultrasound Obstet Gynecol 2021;58:264–277) One of the risk factors for perinatal mortality and morbidity is abnormal fetal growth. The goal of this study was to study the prediction of adverse perinatal outcomes in preterm and term babies based on 3 birth weight (BW) standards (Australian population-based, Fenton, and INTERGROWTH-2...

Objective: Stress during pregnancy may decrease gestational age at birth and birth size. We aimed to investigate the associations between maternal subjective stress measures, salivary cortisol, and perinatal outcomes. Methods: A cohort of pregnant women (n = 1693) was recruited from eight antenatal care clinics, Stockholm, Sweden. Questionnaires...

Background We aimed to study whether pre-eclampsia is associated with childhood asthma, allergic and non-allergic asthma, accounting for family factors and intermediate variables. Methods The study population comprised 779 711 children born in 2005–2012, identified from Swedish national health registers (n = 14 823/7410 exposed to mild/moderate an...

Background The observed association between the parental socioeconomic status (SES, measured as education/income) and asthma or wheezing in offspring may be explained by confounding of unmeasured factors (shared genes and family environment). We aimed to study the association between parental SES and asthma/wheeze using cousin-comparison. Method D...

Emerging evidence suggests trauma experienced in childhood has negative transgenerational implications on offspring mental and physical health. The objective was to investigate whether early life adversity experienced as bereavement is associated with chronic inflammatory health in offspring. The study population included three generations of Swedi...

Focus and outcomes for participants Long periods between exposures and outcomes pose a number of challenges for life course epidemiological research, including unmeasured confounding factors (e.g.; familial factors) and mediation by other covariates, which make it difficult to unequivocally establish associations let alone causality. In this sympos...

Background Gastroesophageal reflux disease (GERD) is the most common non-allergic comorbidity in adults with asthma, however comorbidity with other atopic diseases such as eczema and hayfever is unclear. The objective was to assess the comorbidity of GERD with atopic diseases in adults, and to investigate possible mechanisms including genetic and a...

Background Abnormal fetal growth is a risk factor for perinatal mortality and morbidity. There is considerable debate about the choice and performance of growth charts to classify newborns as small or large for gestational age (SGA and LGA) as a proxy for the at-risk infants. Several international charts have been proposed to be adopted worldwide....

Background: Suicide rates are higher in rural Australia than in major cities, although the factors contributing to this are not well understood. This study highlights trends in suicide and examines the prevalence of mental health problems and service utilisation of non-Indigenous Australians by geographic remoteness in rural Australia. Methods:...

Due to climate change, bushfires are becoming a more frequent and more severe phenomenon which contributes to poor health effects associated with air pollution. In pregnancy, environmental exposures can have lifelong consequences for the fetus, but little is known about these consequences in the context of bushfire smoke exposure. In this review we...

Objective: To evaluate three birthweight standards (Australian population-based, Fenton, and INTERGROWTH-21st ) and three estimated-fetal-weight [EFW] standards (Hadlock, INTERGROWTH-21st , and WHO) for classifying SGA, LGA, and predicting adverse perinatal outcomes in preterm and term babies METHODS: A nationwide population-based study was conduc...

This paper examines the interrelationship between suicide, health, socioeconomic, and psychosocial factors in contributing to suicide in older adults in rural Australia. Drawing on a coronial dataset of suicide cases and a mixed methods sociological autopsy approach, our study integrated a quantitative analysis of 792 suicide cases with a qualitati...

Preterm birth is the leading cause of infant death worldwide, but the causes of preterm birth are largely unknown. During the early COVID-19 lockdowns, dramatic reductions in preterm birth were reported; however, these trends may be offset by increases in stillbirth rates. It is important to study these trends globally as the pandemic continues, an...

Background Australia has one of the highest rates of asthma worldwide. Indigenous children have a particularly high burden of risk determinants for asthma, yet little is known about the asthma risk profile in this population. Aim To identify and quantify potentially preventable risk factors for hospitalised asthma in Australian Aboriginal children...

Background: Development of the gut-brain axis in early life may be disturbed by antibiotic use. It has been hypothesized that this disturbance may contribute to development of neurodevelopmental disorders, including autism spectrum disorder and attention-deficit hyperactivity disorder. We aimed to assess the association between antibiotic use in ea...

Please cite this article as: Robijn AL, Brew BK, Jensen ME, et al. Effect of Maternal Asthma Exacerbations on Perinatal Outcomes: A Population-based Study. ERJ Open Res 2020; in press (https://doi. Take home message: 253/256 characters (spaces incl.) Maternal asthma exacerbations are associated with lower birth weight and increased caesarean sectio...

Background Although there is a growing body of literature about the impact of asthma exacerbations during pregnancy on adverse perinatal outcomes, it is still unclear whether asthma exacerbations themselves or asthma severity are the driving factor for negative outcomes. This study aimed to estimate the associations between maternal asthma exacerba...

Background: Studies suggest an increased all-cause mortality among adults with asthma. We aimed to study the relationship between asthma in children and young adults and all-cause mortality, and investigate differences in mortality rate by also having a life-limiting condition (LLC) or by parental socioeconomic status (SES). Methods: Included in...

Asthma may negatively affect children’s school performance, such as grades and exam results. Results from previous studies have shown varying results and may have suffered from confounding and other biases. We used a Swedish population-based cohort of 570,595 children with data on asthma (including severity and control) in Grades 7–8 and 9, school...

Rationale Early-life antibiotic use has been associated with development of atopic diseases, but the aetiology remains unclear. To elucidate aetiology, we used a discordant twin design to control for genetic and environmental confounding. Methods We conducted a retrospective cohort study in twins (3–10 years) from the Netherlands Twin Register (NT...

‘Asthma’ is a complex disease that encapsulates a heterogeneous group of phenotypes and endotypes. Research to understand these phenotypes has previously been based on longitudinal wheeze patterns or hypothesis-driven observational criteria. The aim of this study was to use data-driven machine learning to identify asthma and wheeze phenotypes in ch...

To evaluate associations between maternal anxiety or depression and adverse pregnancy outcomes, taking possible familial confounding and interaction with asthma into account, we conducted a cohort study of all singleton births in Sweden 2001–2013. We retrieved information about pregnancy, diagnoses of anxiety/depression, asthma, and prescribed medi...

Disproportionate rates of suicide in rural Australia in comparison to metropolitan areas pose a significant public health challenge. The dynamic interrelationship between mental and physical health, social determinants, and suicide in rural Australia is widely acknowledged. Advancement of this knowledge, however, remains hampered by a lack of adequ...

Background Medication charting errors occur often and can be harmful for patients. Interventions to improve charting errors have demonstrated some success particularly if the intervention uses multiple approaches including an education component. The aim of this pilot study was to determine whether a multi-faceted intervention, including education...

Depression, anxiety and high neuroticism (affective traits) are often comorbid with asthma. A causal direction between the affective traits and asthma is difficult to determine, however, there may be a common underlying pathway attributable to shared genetic factors. Our aim was to determine whether a common genetic susceptibility exists for asthma...

Many epidemiological studies have reported a positive association between prenatal exposure to paracetamol and childhood wheezing and asthma. We investigated whether the link between prenatal analgesic exposure and asthma/wheeze is specific to paracetamol, and whether it is causal or confounded. Using linked Swedish health register data we investig...

The extent to which genetic risk factors are shared between childhood-onset (COA) and adult-onset (AOA) asthma has not been estimated. On the basis of data from the UK Biobank study (n = 447,628), we found that the variance in disease liability explained by common variants is higher for COA (onset at ages between 0 and 19 years; h ²g = 25.6%) than...

Background Over a fifth of children and adolescents suffer with asthma or atopic disease. It is unclear whether asthma impacts academic performance in children and adolescents, and little is known about the association of eczema, food allergy or hayfever and academic performance. Objective To examine whether asthma, eczema, food allergy or hayfeve...

Depression, anxiety and high neuroticism (affective traits) are often comorbid with asthma. A causal direction between the affective traits and asthma is difficult to determine, however, it may be that there is a common underlying pathway attributable to shared genetic factors. Our aim was to determine whether a common genetic susceptibility exists...

Purpose Risk factors and consequences of asthma can be studied by using validated questionnaires. The overall objective of this study was to assess the agreement of parental‐reported asthma‐related questions regarding their children against Swedish health care registers. Methods We linked a population‐based twin cohort of 27 055 children aged 9 to...

Aims: Various epidemiological designs have been applied to investigate the causes and consequences of fetal growth restriction in register-based observational studies. This review seeks to provide an overview of several conventional designs, including cohort, case-control and more recently applied non-conventional designs such as family-based desi...

Objective: There is some evidence to suggest that safety on small area farms may not be high priority due to economic constraints and lack of knowledge. This has important ramifications for injury and economic burden. The objective of this research was to conduct a pilot study to investigate whether small to medium area farms implement fewer safet...

Background: Little is known about the joint effects of maternal asthma and maternal depression on childhood asthma. Objective: To examine whether maternal depression and maternal asthma lead to greater risk of childhood asthma than maternal asthma alone. Methods: Cross-sectional studies of children (6-14 years old) in San Juan, Puerto Rico (n...

Background Isolation, long work days, climate change and globalization are just some of the many pressures that make farming a vulnerable occupation for incurring mental health issues. The objective of this study was to determine whether farming in Australia is associated with poorer wellbeing, physical and mental health, and less health service us...

Background: Timing is important for understanding the mechanisms by which maternal distress may affect asthma. Aim: To determine whether there is a critical exposure period for maternal distress on offspring asthma and to explore the mechanisms that may be involved by assessing paternal distress. Methods: The study population included all children...

Introduction: Rural–remote communities report higher smoking rates and poorer health outcomes than that of metropolitan areas. While anti-smoking programs are an important measure for addressing smoking and improving health, little is known of the challenges faced by primary healthcare staff implementing those programs in the rural–remote setting....

Background: As research focuses on the concept of resilience, evidence suggests that greater levels of personal hope may have a mitigating effect on the mental health impact of adversity. In view of the adversity affecting rural communities, a better understanding of factors influencing personal hope may help identify foci for mental health promoti...

Background/objectives: Consumption of oily fish more than once per week has been shown to improve cognitive outcomes in children. However, it is unknown whether similar benefits can be achieved by long-term omega-3 fatty acid supplementation. The objective was to investigate the effect of omega-3 fatty acid supplementation during the first 5 years...

To investigate the relationship between breastfeeding and snoring in childhood. In a cohort of children with a family history of asthma who were recruited antenatally we prospectively recorded data on infant feeding practices throughout the first year of life. Snoring status and witnessed sleep apnea were measured at age 8 years by parent-completed...