{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T03:21:42Z","timestamp":1784604102605,"version":"3.55.0"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Tampere University including Tampere University Hospital, Tampere University of Applied Sciences"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>The aim of this study was to assess the incidence of all major fractures and surgery during pregnancy and the outcomes of pregnancy in Finland between 1998 and 2017.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>A retrospective cohort study using nationwide data from the Finnish Care Register for Health Care and the Finnish Medical Birth Register. As participants we included all women aged between 15 and 49\u00a0years from January 1, 1998 to December 31, 2017 and their\u2009\u2265\u200922-week pregnancies.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of a total 629,911 pregnancies, 1813 pregnant women were hospitalized with a fracture diagnosis, yielding an incidence of 247 fractures\/100,000 pregnancy-years. Of these, 24% (<jats:italic>n<\/jats:italic>\u2009=\u2009513\/2098) were treated operatively. The most common fractures were fractures of the tibia, ankle, and the forearm, which made up half of all fractures. The incidence of pelvic fractures was 6.8\/100,000 pregnancy-years, with an operation rate of 14%. The stillbirth rate of all fracture patients was low at 0.6% (<jats:italic>n<\/jats:italic>\u2009=\u200910\/1813), although this was 1.5-fold the overall stillbirth rate in Finland. Lumbosacral and comminuted spinopelvic fractures resulted in preterm delivery in 25% (<jats:italic>n<\/jats:italic>\u2009=\u20095\/20) of parturients, with a stillbirth rate of 10% (<jats:italic>n<\/jats:italic>\u2009=\u20092\/20).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The incidence of fracture hospitalization during pregnancy is lower than in the general population, and fractures in this population are more often treated conservatively. A higher proportion of preterm deliveries and stillbirths occurred in women with lumbosacral and comminuted spinopelvic fractures. Maternal mortality and stillbirth rates remain low among women with fractures leading to hospitalization or surgery during pregnancy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00402-023-04931-w","type":"journal-article","created":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T09:01:51Z","timestamp":1686646911000},"page":"5719-5725","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Incidence of fracture hospitalization and surgery during pregnancy in Finland\u20141998\u20132017: a retrospective register-based cohort study"],"prefix":"10.1007","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6291-4869","authenticated-orcid":false,"given":"Lauri","family":"Nyrhi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilari","family":"Kuitunen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ville","family":"Ponkilainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomas T.","family":"Huttunen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ville M.","family":"Mattila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,13]]},"reference":[{"key":"4931_CR1","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1097\/00005373-199205000-00017","volume":"32","author":"J Fildes","year":"1992","unstructured":"Fildes J, Reed L, Jones N, Martin MBJ (1992) Trauma: the leading cause of maternal death. J Trauma 32:643\u2013645","journal-title":"J Trauma"},{"key":"4931_CR2","doi-asserted-by":"publisher","first-page":"175","DOI":"10.5435\/00124635-200603000-00008","volume":"14","author":"K Flik","year":"2006","unstructured":"Flik K, Kloen P, Toro JB et al (2006) Orthopaedic trauma in the pregnant patient. J Am Acad Orthop Surg 14:175\u2013182. https:\/\/doi.org\/10.5435\/00124635-200603000-00008","journal-title":"J Am Acad Orthop Surg"},{"key":"4931_CR3","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1097\/00005373-200211000-00021","volume":"53","author":"MA Schiff","year":"2002","unstructured":"Schiff MA, Holt VL, Daling JR (2002) Maternal and infant outcomes after injury during pregnancy in Washington State from 1989 to 1997. J Trauma 53:939\u2013945. https:\/\/doi.org\/10.1097\/00005373-200211000-00021","journal-title":"J Trauma"},{"key":"4931_CR4","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.1016\/j.ajog.2004.02.051","volume":"190","author":"D El-Kady","year":"2004","unstructured":"El-Kady D, Gilbert WM, Anderson J et al (2004) Trauma during pregnancy: an analysis of maternal and fetal outcomes in a large population. Am J Obstet Gynecol 190:1661\u20131668. https:\/\/doi.org\/10.1016\/j.ajog.2004.02.051","journal-title":"Am J Obstet Gynecol"},{"key":"4931_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ajog.2013.01.021","volume":"209","author":"H Mendez-Figueroa","year":"2013","unstructured":"Mendez-Figueroa H, Dahlke JD, Vrees RA, Rouse DJ (2013) Trauma in pregnancy: an updated systematic review. Am J Obstet Gynecol 209:1\u201310. https:\/\/doi.org\/10.1016\/j.ajog.2013.01.021","journal-title":"Am J Obstet Gynecol"},{"key":"4931_CR6","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1097\/00005131-200005000-00003","volume":"14","author":"HC Pape","year":"2000","unstructured":"Pape HC, Pohlemann T, G\u00e4nsslen A et al (2000) Pelvic fractures in pregnant multiple trauma patients. J Orthop Trauma 14:238\u2013244. https:\/\/doi.org\/10.1097\/00005131-200005000-00003","journal-title":"J Orthop Trauma"},{"key":"4931_CR7","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-197403000-00001","author":"SP Baker","year":"1974","unstructured":"Baker SP, O\u2019Neill B, Haddon W, Long WB (1974) The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. https:\/\/doi.org\/10.1097\/00005373-197403000-00001","journal-title":"J Trauma"},{"key":"4931_CR8","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1097\/00005373-199705000-00005","volume":"42","author":"J Ali","year":"1997","unstructured":"Ali J, Yeo A, Gana TJ, McLellan BA (1997) Predictors of fetal mortality in pregnant trauma patients. J Trauma 42:782\u2013785. https:\/\/doi.org\/10.1097\/00005373-199705000-00005","journal-title":"J Trauma"},{"key":"4931_CR9","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1097\/00005373-200210000-00033","volume":"53","author":"RE Leggon","year":"2002","unstructured":"Leggon RE, Wood GC, Indeck MC (2002) Pelvic fractures in pregnancy: factors influencing maternal and fetal outcomes. J Trauma 53:796\u2013804. https:\/\/doi.org\/10.1097\/00005373-200210000-00033","journal-title":"J Trauma"},{"key":"4931_CR10","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1016\/j.injury.2012.03.009","volume":"43","author":"G Maliha","year":"2012","unstructured":"Maliha G, Morgan J, Vrahas M (2012) Transient osteoporosis of pregnancy. Injury 43:1237\u20131241. https:\/\/doi.org\/10.1016\/j.injury.2012.03.009","journal-title":"Injury"},{"key":"4931_CR11","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1097\/GCO.0b013e3283404ea1","volume":"22","author":"I-H Han","year":"2010","unstructured":"Han I-H (2010) Pregnancy and spinal problems. Curr Opin Obstet Gynecol 22:477\u2013481. https:\/\/doi.org\/10.1097\/GCO.0b013e3283404ea1","journal-title":"Curr Opin Obstet Gynecol"},{"key":"4931_CR12","doi-asserted-by":"publisher","first-page":"1410","DOI":"10.1016\/j.injury.2021.03.013","volume":"52","author":"N Lundin","year":"2021","unstructured":"Lundin N, Huttunen TT, Berg HE et al (2021) Increasing incidence of pelvic and acetabular fractures. A nationwide study of 87,308 fractures over a 16-year period in Sweden. Injury 52:1410\u20131417. https:\/\/doi.org\/10.1016\/j.injury.2021.03.013","journal-title":"Injury"},{"key":"4931_CR13","doi-asserted-by":"publisher","first-page":"267","DOI":"10.2147\/IJWH.S198345","volume":"11","author":"JA Harold","year":"2019","unstructured":"Harold JA, Isaacson E, Palatnik A (2019) Femoral fracture in pregnancy: a case series and review of clinical management. Int J Womens Health 11:267\u2013271. https:\/\/doi.org\/10.2147\/IJWH.S198345","journal-title":"Int J Womens Health"},{"key":"4931_CR14","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s13017-017-0117-6","volume":"12","author":"F Coccolini","year":"2017","unstructured":"Coccolini F, Stahel PF, Montori G et al (2017) Pelvic trauma: WSES classification and guidelines. World J Emerg Surg 12:5. https:\/\/doi.org\/10.1186\/s13017-017-0117-6","journal-title":"World J Emerg Surg"},{"key":"4931_CR15","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1016\/j.injury.2008.05.007","volume":"39","author":"VM Mattila","year":"2008","unstructured":"Mattila VM, Sillanp\u00e4\u00e4 P, Iivonen T et al (2008) Coverage and accuracy of diagnosis of cruciate ligament injury in the Finnish National Hospital Discharge Register. Injury 39:1373\u20131376. https:\/\/doi.org\/10.1016\/j.injury.2008.05.007","journal-title":"Injury"},{"key":"4931_CR16","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1177\/1403494812456637","volume":"40","author":"R Sund","year":"2012","unstructured":"Sund R (2012) Quality of the Finnish Hospital discharge register: a systematic review. Scand J Public Health 40:505\u2013515. https:\/\/doi.org\/10.1177\/1403494812456637","journal-title":"Scand J Public Health"},{"key":"4931_CR17","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/1471-2474-15-98","volume":"15","author":"TT Huttunen","year":"2014","unstructured":"Huttunen TT, Kannus P, Pihlajam\u00e4ki H, Mattila VM (2014) Pertrochanteric fracture of the femur in the Finnish National Hospital discharge register: validity of procedural coding, external cause for injury and diagnosis. BMC Musculoskelet Disord 15:98. https:\/\/doi.org\/10.1186\/1471-2474-15-98","journal-title":"BMC Musculoskelet Disord"},{"key":"4931_CR18","unstructured":"Finnish Institute for Health and Welfare (2021) Perinatal statistics. In: Perinat. Stat. https:\/\/urn.fi\/URN:NBN:fi-fe2022112867358. Accessed 28 Mar 2023"},{"key":"4931_CR19","unstructured":"Organization WH (2016) International classification of diseases. https:\/\/icd.who.int\/browse10\/2016\/en. Accessed 28 Mar 2023"},{"key":"4931_CR20","unstructured":"Nordic Centre for Classifications in Health Care (2010) NOMESCO classification of surgical procedures (NCSP), version 1.15. https:\/\/norden.diva-portal.org\/smash\/get\/diva2:970547\/FULLTEXT01.pdf. Accessed 20 Dec 2022"},{"key":"4931_CR21","volume-title":"Reproductive health indicators\u2014guidelines for their generation, interpretation and analysis for global monitoring","author":"World Health Organisation","year":"2006","unstructured":"World Health Organisation (2006) Reproductive health indicators\u2014guidelines for their generation, interpretation and analysis for global monitoring. WHO, Geneva"},{"key":"4931_CR22","unstructured":"The Finnish National Board on Research Integrity (2021) The review of the ethics committee is not required for the research of public and published data, registry and documentary data and archive data. https:\/\/tenk.fi\/en\/advice-and-materials\/guidelines-ethical-review-human-sciences. Accessed 20 Dec 2022"},{"key":"4931_CR23","doi-asserted-by":"publisher","first-page":"573","DOI":"10.7326\/0003-4819-147-8-200710160-00010","volume":"147","author":"E von Elm","year":"2007","unstructured":"von Elm E, Altman DG, Egger M et al (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med 147:573\u2013577. https:\/\/doi.org\/10.7326\/0003-4819-147-8-200710160-00010","journal-title":"Ann Intern Med"},{"key":"4931_CR24","first-page":"717","volume":"90","author":"NJ Murphy","year":"2014","unstructured":"Murphy NJ, Quinlan JD (2014) Trauma in pregnancy: assessment, management, and prevention. Am Fam Physician 90:717\u2013722","journal-title":"Am Fam Physician"},{"key":"4931_CR25","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1016\/j.injury.2006.04.130","volume":"37","author":"CM Court-Brown","year":"2006","unstructured":"Court-Brown CM, Caesar B (2006) Epidemiology of adult fractures: a review. Injury 37:691\u2013697. https:\/\/doi.org\/10.1016\/j.injury.2006.04.130","journal-title":"Injury"},{"key":"4931_CR26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0244291","volume":"15","author":"C Bergh","year":"2020","unstructured":"Bergh C, Wennergren D, M\u00f6ller M, Brisby H (2020) Fracture incidence in adults in relation to age and gender: a study of 27,169 fractures in the Swedish Fracture Register in a well-defined catchment area. PLoS One 15:e0244291. https:\/\/doi.org\/10.1371\/journal.pone.0244291","journal-title":"PLoS One"},{"key":"4931_CR27","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1016\/j.injury.2017.04.047","volume":"48","author":"MSH Beerekamp","year":"2017","unstructured":"Beerekamp MSH, de Muinck Keizer RJO, Schep NWL et al (2017) Epidemiology of extremity fractures in the Netherlands. Injury 48:1355\u20131362. https:\/\/doi.org\/10.1016\/j.injury.2017.04.047","journal-title":"Injury"},{"key":"4931_CR28","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1097\/BRS.0000000000003286","volume":"45","author":"VT Ponkilainen","year":"2020","unstructured":"Ponkilainen VT, Toivonen L, Niemi S et al (2020) Incidence of spine fracture hospitalization and surgery in Finland in 1998\u20132017. Spine (Phila Pa 1976) 45:459\u2013464. https:\/\/doi.org\/10.1097\/BRS.0000000000003286","journal-title":"Spine (Phila Pa 1976)"},{"key":"4931_CR29","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1080\/17453674.2020.1771827","volume":"91","author":"PP Rinne","year":"2020","unstructured":"Rinne PP, Laitinen MK, Kannus P, Mattila VM (2020) The incidence of pelvic fractures and related surgery in the Finnish adult population: a nationwide study of 33,469 patients between 1997 and 2014. Acta Orthop 91:587\u2013592. https:\/\/doi.org\/10.1080\/17453674.2020.1771827","journal-title":"Acta Orthop"},{"key":"4931_CR30","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1016\/j.ecl.2015.05.002","volume":"44","author":"BC Lupsa","year":"2015","unstructured":"Lupsa BC, Insogna K (2015) Bone Health and Osteoporosis. Endocrinol Metab Clin North Am 44:517\u2013530. https:\/\/doi.org\/10.1016\/j.ecl.2015.05.002","journal-title":"Endocrinol Metab Clin North Am"},{"key":"4931_CR31","volume-title":"Femoral shaft fractures","author":"M Denisiuk","year":"2022","unstructured":"Denisiuk M, Afsari A (2022) Femoral shaft fractures. StatPearls Publishing, Florida"},{"key":"4931_CR32","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1136\/bjsports-2018-100056","volume":"52","author":"MF Mottola","year":"2018","unstructured":"Mottola MF, Davenport MH, Ruchat S-M et al (2018) 2019 Canadian guideline for physical activity throughout pregnancy. Br J Sports Med 52:1339\u20131346. https:\/\/doi.org\/10.1136\/bjsports-2018-100056","journal-title":"Br J Sports Med"},{"key":"4931_CR33","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s12966-017-0485-z","volume":"14","author":"C Fazzi","year":"2017","unstructured":"Fazzi C, Saunders DH, Linton K et al (2017) Sedentary behaviours during pregnancy: a systematic review. Int J Behav Nutr Phys Act 14:32. https:\/\/doi.org\/10.1186\/s12966-017-0485-z","journal-title":"Int J Behav Nutr Phys Act"},{"key":"4931_CR34","doi-asserted-by":"publisher","first-page":"17891","DOI":"10.1038\/s41598-020-74753-y","volume":"10","author":"A Riuttanen","year":"2020","unstructured":"Riuttanen A, J\u00e4ntti SJ, Mattila VM (2020) Alcohol use in severely injured trauma patients. Sci Rep 10:17891. https:\/\/doi.org\/10.1038\/s41598-020-74753-y","journal-title":"Sci Rep"},{"key":"4931_CR35","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1097\/00005131-200309000-00008","volume":"17","author":"ML Wood","year":"2003","unstructured":"Wood ML, Larson CM, Dahners LE (2003) Late presentation of a displaced subcapital fracture of the hip in transient osteoporosis of pregnancy. J Orthop Trauma 17:582\u2013584. https:\/\/doi.org\/10.1097\/00005131-200309000-00008","journal-title":"J Orthop Trauma"},{"key":"4931_CR36","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1186\/1757-1626-1-120","volume":"1","author":"CA Willis-Owen","year":"2008","unstructured":"Willis-Owen CA, Daurka JS, Chen A, Lewis A (2008) Bilateral femoral neck fractures due to transient osteoporosis of pregnancy: a case report. Cases J 1:120. https:\/\/doi.org\/10.1186\/1757-1626-1-120","journal-title":"Cases J"},{"key":"4931_CR37","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1177\/230949901202000227","volume":"20","author":"MJ Emami","year":"2012","unstructured":"Emami MJ, Abdollahpour HR, Kazemi AR, Vosoughi AR (2012) Bilateral subcapital femoral neck fractures secondary to transient osteoporosis during pregnancy: a case report. J Orthop Surg (Hong Kong) 20:260\u2013262. https:\/\/doi.org\/10.1177\/230949901202000227","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"4931_CR38","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1002\/jbmr.5650110519","volume":"11","author":"LA Kohlmeier","year":"1996","unstructured":"Kohlmeier LA, Federman M, Leboff MS (1996) Osteomalacia and osteoporosis in a woman with ankylosing spondylitis. J Bone Miner Res 11:697\u2013703. https:\/\/doi.org\/10.1002\/jbmr.5650110519","journal-title":"J Bone Miner Res"},{"key":"4931_CR39","doi-asserted-by":"publisher","first-page":"127","DOI":"10.2106\/00004623-199501000-00016","volume":"77","author":"RJ Fingeroth","year":"1995","unstructured":"Fingeroth RJ (1995) Successful operative treatment of a displaced subcapital fracture of the hip in transient osteoporosis of pregnancy. A case report and review of the literature. J Bone Joint Surg Am 77:127\u2013131. https:\/\/doi.org\/10.2106\/00004623-199501000-00016","journal-title":"J Bone Joint Surg Am"},{"key":"4931_CR40","doi-asserted-by":"publisher","first-page":"1830","DOI":"10.1016\/j.injury.2018.06.044","volume":"49","author":"SM Mann","year":"2018","unstructured":"Mann SM, Banaszek D, Lajkosz K et al (2018) High-energy trauma patients with pelvic fractures: management trends in Ontario, Canada. Injury 49:1830\u20131840. https:\/\/doi.org\/10.1016\/j.injury.2018.06.044","journal-title":"Injury"},{"key":"4931_CR41","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1097\/TA.0b013e3181589fa4","volume":"63","author":"Z Balogh","year":"2007","unstructured":"Balogh Z, King KL, Mackay P et al (2007) The epidemiology of pelvic ring fractures: a population-based study. J Trauma 63:1066\u20131073. https:\/\/doi.org\/10.1097\/TA.0b013e3181589fa4. (discussion 1072\u20131073)","journal-title":"J Trauma"},{"key":"4931_CR42","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.1001\/jama.286.15.1863","volume":"286","author":"HB Weiss","year":"2001","unstructured":"Weiss HB, Songer TJ, Fabio A (2001) Fetal deaths related to maternal injury. JAMA 286:1863\u20131868. https:\/\/doi.org\/10.1001\/jama.286.15.1863","journal-title":"JAMA"}],"container-title":["Archives of Orthopaedic and Trauma Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-023-04931-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00402-023-04931-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-023-04931-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T03:31:39Z","timestamp":1692934299000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00402-023-04931-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,13]]},"references-count":42,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["4931"],"URL":"https:\/\/doi.org\/10.1007\/s00402-023-04931-w","relation":{},"ISSN":["1434-3916"],"issn-type":[{"value":"1434-3916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,13]]},"assertion":[{"value":"24 December 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 May 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None were declared.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}