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BACKGROUND: Adverse pregnancy outcomes (APO) contribute to higher risk of maternal cerebrovascular disease, but longitudinal data that include APO and stroke timing are lacking. We hypothesized that APO are associated with younger age at first stroke, with a stronger relationship in those with >1 pregnancy with APO. METHODS: We analyzed longitudinal Finnish nationwide health registry data from the FinnGen Study. We included women who gave birth after 1969 when the hospital discharge registry was established. We defined APO as a pregnancy affected by gestational hypertension, preeclampsia, eclampsia, preterm birth, small for gestational age infant, or placental abruption. We defined stroke as first hospital admission for ischemic stroke or nontraumatic intracerebral or subarachnoid hemorrhage, excluding stroke during pregnancy or within 1 year postpartum. We used Kaplan-Meier survival curves and multivariable-adjusted Cox and generalized linear models to assess the relationship between APO and future stroke. RESULTS: We included 144 306 women with a total of 316 789 births in the analysis sample, of whom 17.9% had at least 1 pregnancy with an APO and 2.9% experienced an APO in ≥2 pregnancies. Women with APO had more comorbidities including obesity, hypertension, heart disease, and migraine. Median age at first stroke was 58.3 years in those with no APO, 54.8 years in those with 1 APO, and 51.6 years in those with recurrent APO. In models adjusted for sociodemographic characteristics and stroke risk factors, risk of stroke was greater in women with 1 APO (adjusted hazard ratio, 1.3 [95% CI, 1.2–1.4]) and recurrent APO (adjusted hazard ratio, 1.4 [95% CI, 1.2–1.7]) compared with those with no APO. Women with recurrent APO had more than twice the stroke risk before age 45 (adjusted odds ratio, 2.1 [95% CI, 1.5–3.1]) compared with those without APO. CONCLUSIONS: Women who experience APO have earlier onset of cerebrovascular disease, with the earliest onset in those with more than 1 affected pregnancy.

Whenever a diagnosis is given, a procedure is performed, or a drug is prescribed, it leads to an entry into an electronic health record (EHR) system. Previously, this data was difficult to utilize because of rules regarding confidentiality, but new security approaches and pseudonymization have enabled us to work with this data. Health-related data is voluminous and complex, and it can be difficult to abstract a meaningful overview. One of the complexities is its longitudinality. Often medical research is cross-sectional - we often take a point in time for analysis, when instead, it might be more beneficial to see the trajectory that led to the point in time. We are currently developing a trajectory visualization tool for longitudinal electronic health data. It is a web-based tool that interfaces with the OHDSI data infrastructure and visualizes the cohorts and concept sets (groups of medical codes) defined via the OHDSI Atlas GUI. Currently, our tool is in user testing and it will be deployed to a wider user group during the spring. The user feedback has been positive. Users find the tool especially useful in understanding and debugging their OHDSI Atlas cohort definitions. acceptedVersion

Genetic data from ancient and modern domestic animals holds tremendous potential to reveal long term trends in population histories. Reconstruction of effective population sizes based on temporally well covered data may reveal the effects of particular events in the early history of animal populations as well as reflect the changes in the lifestyle and society of past human populations. We used an Extended Bayesian Skyline Plot approach to estimate the effective population sizes (Ne) and their temporal changes in sheep and cattle from Late Bronze Age to present in North-East Baltic Sea Region (NEBSR). The results support previous results from ancient DNA analyses (mtDNA, Y-chromosome, MC1R) in the NEBSR for cattle and reveal previously unidentified temporal fluctuation for sheep (mtDNA, Y-chromosome). The sheep and cattle Ne increased during the Iron Age, reaching their maximum at the Late Iron Age/Medieval period followed by deep decline in sizes until the present. Decline in Ne simultaneously with increase in total population sizes indicate selection and increasing inbreeding from the beginning of Post Medieval period to the middle of the 20th century. The timing of the increase in sheep and cattle Ne is roughly the same as the timing of transition from hunting-gathering to farming in Iron Age (400–1000 CE).

Summary Sheep were among the first domesticated animals to appear in Estonia in the late Neolithic and became one of the most widespread livestock species in the region from the Late Bronze Age onwards. However, the origin and historical expansion of local sheep populations in Estonia remain poorly understood. Here, we analysed fragments of the hypervariable D-loop of mitochondrial DNA (mtDNA; 213 bp) and the Y-chromosome SRY gene (130 bp) extracted from 31 archaeological sheep bones dated from approximately 800 BC to 1700 AD. The ancient DNA data of sheep from Estonia were compared with ancient sheep from Finland as well as a set of contemporary sheep breeds from across Eurasia in order to place them in a wider phylogeographical context. The analysis shows that: (i) 24 successfully amplified and analysed mtDNA sequences of ancient sheep cluster into two haplogroups, A and B, of which B is predominant; (ii) four of the ancient mtDNA haplotypes are novel; (iii) higher mtDNA haplotype diversity occurred during the Middle Ages as compared to other periods, a fact concordant with the historical context of expanding international trade during the Middle Ages; (iv) the proportion of rarer haplotypes declined during the expansion of sheep from the Near Eastern domestication centre to the northern European region; (v) three male samples showed the presence of the characteristic northern European haplotype, SNP G-oY1 of the Y-chromosome, and represent the earliest occurrence of this haplotype. Our results provide the first insight into the genetic diversity and phylogeographical background of ancient sheep in Estonia and provide basis for further studies on the temporal fluctuations of ancient sheep populations.