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All authors have completed the ICMJE uniform disclosure form and declare support from the National Science and Technology Council of Taiwan and the National Health Research Institutes of Taiwan for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work during the preceding 3 years; and no professional interests, personal relationships, or personal beliefs that could impart bias on the submitted work. The authors confirm they have considered the journal\u2019s competing interests policy in full.","order":1,"name":"Ethics","label":"Conflicts of interest\/competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Human Research Ethics Committee of National Cheng Kung University (approval number NCKU HREC-E-112-512). This study was performed in accordance with the Declaration of Helsinki (1964) and its subsequent amendments.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. The study analyzed de-identified secondary administrative data held by the Health and Welfare Data Science Center, Ministry of Health and Welfare, Taiwan. No participants were contacted and no identifiable information was accessible to the investigators. The Human Research Ethics Committee of National Cheng Kung University granted a waiver of informed consent on this basis.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. The article contains no individual-level data, images, or other information from which any person could be identified.","order":4,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The data underlying this study were obtained from the Health and Welfare Data Science Center, Ministry of Health and Welfare, Taiwan, and comprise the National Health Insurance Research Database, the Birth Certificate Application database, and the Maternal and Child Health Database. Under the Personal Data Protection Act and the terms of the data use agreement, these data cannot be shared publicly by the authors. Access is available to qualified researchers through application to the Health and Welfare Data Science Center.","order":5,"name":"Ethics","label":"Availability of data and material","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The analytic code implementing the hierarchical linkage algorithm is provided in Method S1 of the ESM in sufficient detail for reimplementation. We performed statistical analyses using SAS 9.4 (SAS Institute) and R 4.4.1 (R Foundation for Statistical Computing). The corresponding author will provide the analytic code used to generate the reported results upon reasonable request, subject to the Health and Welfare Data Science Center\u2019s data governance terms.","order":6,"name":"Ethics","label":"Code availability","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors initiated the collaborative project, accessed and verified the underlying data reported in the manuscript, interpreted the results, and reviewed the manuscript. BMHL and MCYC developed research questions, designed the study protocol, and conducted the statistical analysis. BMHL drafted the manuscript. ECCL supervised the study and served as the guarantor. All authors revised the manuscript critically for important intellectual content. All authors read and approved the final version. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.","order":7,"name":"Ethics","label":"Authors\u2019 contributions","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Large language model tools were used for language editing of author-written text. No AI tool was used for the study design, data extraction, statistical analysis, interpretation of results, image generation, or reference selection. All authors reviewed and accepted responsibility for the final text.","order":8,"name":"Ethics","label":"AI use","group":{"name":"EthicsHeading","label":"Declarations"}}]}}