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Sorbye LM, Cnattingius S, Skjaerven R, Klungsoyr K, Wikström AK, Kvalvik LG, Morken NH. Interpregnancy weight change and recurrence of gestational diabetes mellitus: a population-based cohort study. BJOG 2020; 127:1608-1616. [PMID: 32534460 DOI: 10.1111/1471-0528.16364] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To estimate recurrence risk of gestational diabetes mellitus (GDM) by interpregnancy weight change. DESIGN Population-based cohort study. SETTING AND POPULATION Data from the Swedish (1992-2010) and the Norwegian (2006-2014) Medical Birth Registries on 2763 women with GDM in first pregnancy, registered with their first two singleton births and available information on height and weight. METHODS Interpregnancy weight change (BMI in second pregnancy minus BMI in first pregnancy) was categorised in six groups by BMI units. Relative risks (RRs) of GDM recurrence were obtained by general linear models for the binary family and adjusted for confounders. Analyses were stratified by BMI in first pregnancy (<25 and ≥25 kg/m2 ). MAIN OUTCOME MEASURE GDM in second pregnancy. RESULTS Among overweight/obese women (BMI ≥25), recurrence risk of GDM decreased in women who reduced their BMI by 1-2 units (relative risk [RR] 0.80, 95% CI 0.65-0.99) and >2 units (RR 0.72, 95% CI 0.59-0.89) and increased if BMI increased by ≥4 units (RR 1.26, 95% CI 1.05-1.51) compared wth women with stable BMI (-1 to 1 units). In normal weight women (BMI <25), risk of GDM recurrence increased if BMI increased by 2-4 units (RR 1.32, 95% CI 1.08-1.60) and ≥4 units (RR 1.61, 95% CI 1.28-2.02) compared with women with stable BMI. CONCLUSION Interpregnancy weight loss reduced risk of GDM recurrence in overweight/obese women. Weight gain between pregnancies increased recurrence risk for GDM in both normal and overweight/obese women. Our findings highlight the importance of weight management in the interconception window in women with a history of GDM. TWEETABLE ABSTRACT Interpregnancy weight loss reduces recurrence of gestational diabetes mellitus in overweight/obese women.
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Affiliation(s)
- L M Sorbye
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - S Cnattingius
- Department of Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - R Skjaerven
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - K Klungsoyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Division for Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - A-K Wikström
- Department of Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - L G Kvalvik
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Biomedicine, University of Bergen, Bergen, Norway
| | - N-H Morken
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
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Sorbye LM, Skjaerven R, Klungsoyr K, Morken NH. Gestational diabetes mellitus and interpregnancy weight change: A population-based cohort study. PLoS Med 2017; 14:e1002367. [PMID: 28763446 PMCID: PMC5538633 DOI: 10.1371/journal.pmed.1002367] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 06/26/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Being overweight is an important risk factor for Gestational Diabetes Mellitus (GDM), but the underlying mechanisms are not understood. Weight change between pregnancies has been suggested to be an independent mechanism behind GDM. We assessed the risk for GDM in second pregnancy by change in Body Mass Index (BMI) from first to second pregnancy and whether BMI and gestational weight gain modified the risk. METHODS AND FINDINGS In this observational cohort, we included 24,198 mothers and their 2 first pregnancies in data from the Medical Birth Registry of Norway (2006-2014). Weight change, defined as prepregnant BMI in second pregnancy minus prepregnant BMI in first pregnancy, was divided into 6 categories by units BMI (kilo/square meter). Relative risk (RR) estimates were obtained by general linear models for the binary family and adjusted for maternal age at second delivery, country of birth, education, smoking in pregnancy, interpregnancy interval, and year of second birth. Analyses were stratified by BMI (first pregnancy) and gestational weight gain (second pregnancy). Compared to women with stable BMI (-1 to 1), women who gained weight between pregnancies had higher risk of GDM-gaining 1 to 2 units: adjusted RR 2.0 (95% CI 1.5 to 2.7), 2 to 4 units: RR 2.6 (2.0 to 3.5), and ≥4 units: RR 5.4 (4.0 to 7.4). Risk increased significantly both for women with BMI below and above 25 at first pregnancy, although it increased more for the former group. A limitation in our study was the limited data on BMI in 2 pregnancies. CONCLUSIONS The risk of GDM increased with increasing weight gain from first to second pregnancy, and more strongly among women with BMI < 25 in first pregnancy. Our results suggest weight change as a metabolic mechanism behind the increased risk of GDM, thus weight change should be acknowledged as an independent factor for screening GDM in clinical guidelines. Promoting healthy weight from preconception through the postpartum period should be a target.
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Affiliation(s)
- L. M. Sorbye
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian National Advisory Unit on Women’s Health, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - R. Skjaerven
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen, Norway
| | - K. Klungsoyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen, Norway
| | - N. H. Morken
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
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Morken NH, Halland F, DeRoo LA, Wilcox AJ, Skjaerven R. Offspring birthweight by gestational age and parental cardiovascular mortality: a population-based cohort study. BJOG 2017; 125:336-341. [PMID: 28165208 DOI: 10.1111/1471-0528.14522] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To estimate risk of parental cardiovascular disease mortality by offspring birthweight. DESIGN Population-based cohort study. SETTING AND POPULATION Norwegian mothers and fathers with singleton births during 1967-2002 were followed until 2009 by linkage to the Norwegian cause of death registry. METHODS Hazard ratios by offspring absolute birthweight in grams and birthweight adjusted for gestational age (z-score) were calculated using Cox regression and adjusted for parental age at delivery and year of first birth. Stratified analyses on preterm and term births were performed. MAIN OUTCOME MEASURES Maternal and paternal cardiovascular mortality. RESULTS We followed 711 726 mothers and 700 212 fathers and found a strong link between maternal cardiovascular mortality and offspring birthweight but only slight evidence of associations in fathers. Adjusting birthweight for gestational age (by z-score) uncovered an unexpected strong association of large birthweight (z-score > 2.5) with mothers' cardiovascular mortality (hazard ratio 3.0, 95% CI 2.0-4.6). This risk was apparently restricted to preterm births. In stratified analyses (preterm and term births) hazard ratios for maternal cardiovascular mortality were 1.5 (1.03-2.2) for large preterm babies and 0.9 (0.7-1.2) for large term babies (P-value for interaction = 0.02), using normal weight preterm and term, respectively, as references. CONCLUSION Women having large preterm babies are at increased risk of both diabetes and cardiovascular mortality. The birth of a large preterm baby should increase clinical vigilance for onset of diabetes and other cardiovascular disease risk factors. TWEETABLE ABSTRACT Birth of a large preterm baby should increase vigilance for cardiovascular-disease risk factors.
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Affiliation(s)
- N-H Morken
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Obstetrics & Gynaecology, Haukeland University Hospital, Bergen, Norway
| | - F Halland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Obstetrics & Gynaecology, Haukeland University Hospital, Bergen, Norway
| | - L A DeRoo
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Epidemiology Branch, NIEHS/NIH, Durham, NC, USA
| | - A J Wilcox
- Epidemiology Branch, NIEHS/NIH, Durham, NC, USA
| | - R Skjaerven
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Medical Birth Registry of Norway, Bergen, Norway.,Norwegian Institute of Public Health, Bergen, Norway
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Henningsen AA, Gissler M, Skjaerven R, Bergh C, Tiitinen A, Romundstad LB, Wennerholm UB, Lidegaard O, Nyboe Andersen A, Forman JL, Pinborg A. Trends in perinatal health after assisted reproduction: a Nordic study from the CoNARTaS group. Hum Reprod 2015; 30:710-6. [PMID: 25605701 DOI: 10.1093/humrep/deu345] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTIONS Has the perinatal outcome of children conceived after assisted reproductive technology (ART) improved over time? SUMMARY ANSWER The perinatal outcomes in children born after ART have improved over the last 20 years, mainly due to the reduction of multiple births. WHAT IS KNOWN AND WHAT THIS PAPER ADDS A Swedish study has shown a reduction in unwanted outcomes over time in children conceived after ART. Our analyses based on data from more than 92 000 ART children born in four Nordic countries confirm these findings. STUDY DESIGN Nordic population-based matched cohort study with ART outcome and health data from Denmark, Finland, Norway and Sweden. PARTICIPANTS, SETTING AND METHODS We analysed the perinatal outcome of 62 379 ART singletons and 29 758 ART twins, born from 1988 to 2007 in four Nordic countries. The ART singletons were compared with a control group of 362 215 spontaneously conceived singletons. Twins conceived after ART were compared with all spontaneously conceived twins (n = 122 763) born in the Nordic countries during the study period. The rates of several adverse perinatal outcomes were stratified into the time periods: 1988-1992; 1993-1997; 1998-2002 and 2003-2007 and presented according to multiplicity. MAIN RESULTS AND ROLE OF CHANCE For singletons conceived after ART, a remarkable decline in the risk of being born preterm and very preterm was observed. The proportion of ART singletons born with a low and very low birthweight also decreased. Finally, the stillbirth and infant death rates have declined among both ART singletons and twins. Throughout the 20 year period, fewer ART twins were stillborn or died during the first year of life compared with spontaneously conceived twins, presumably due to the lower proportion of monozygotic twins among the ART twins. LIMITATIONS, REASONS FOR CAUTION We were not able to adjust for some potential confounders such as BMI, smoking, length or cause of infertility. The Nordic ART populations have changed over time, and in recent years, both less as well as severely reproductive ill couples are being treated. This may have affected the observed trends. WIDER IMPLICATIONS OF THE FINDINGS It is assuring that data from four countries confirm an overall improvement over time in the perinatal outcomes of children conceived after ART. Furthermore, data show the beneficial effect of single embryo transfer, not only in regard to lowering the rate of multiples but also concerning the health of singletons. STUDY FUNDING/COMPETING INTERESTS The European Society for Human Reproduction and Embryology (ESHRE), the University of Copenhagen and the Danish Agency for Science, Technology and Innovation has supported the project. The CoNARTaS group has received travel and meeting funding from the Nordic Federation of Obstetrics and Gynecology (NFOG). None of the authors has any competing interests to declare.
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Affiliation(s)
- A A Henningsen
- Fertility Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - M Gissler
- THL, National Institute for Health and Welfare, Helsinki, Finland Nordic School of Public Health, Gothenburg, Sweden
| | - R Skjaerven
- Department of Global Public Health and Primary Health Care, University of Bergen, Bergen, Norway Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen, Norway
| | - C Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - A Tiitinen
- Department of Obstetrics and Gynecology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - L B Romundstad
- Department of Obstetrics and Gynecology, Fertility Clinic, St Olav's University Hospital, Trondheim, Norway Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - U B Wennerholm
- Perinatal Centre, Department of Obstetrics and Gynecology, Institute for Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
| | - O Lidegaard
- Gynecological Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - A Nyboe Andersen
- Fertility Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - J L Forman
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - A Pinborg
- Department of Obstetrics and Gynecology, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
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Henningsen AKA, Wennerholm UB, Gissler M, Romundstad LB, Nygren KG, Tiitinen A, Skjaerven R, Andersen AN, Lidegaard O, Forman JL, Pinborg A. Reply: Implication of the liberal use of ART in Nordic countries: should stricter guidelines be created to prevent unnecessary stillbirth and preterm delivery? Hum Reprod 2014; 29:2600-1. [DOI: 10.1093/humrep/deu244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Morken NH, Skjaerven R, Wilcox AJ. Ultrasound prediction of perinatal outcome: the unrecognised value of sibling data. BJOG 2014; 122:1674-81. [DOI: 10.1111/1471-0528.13022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2014] [Indexed: 10/24/2022]
Affiliation(s)
- N-H Morken
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
- Department of Clinical Sciences; University of Bergen; Bergen Norway
| | - R Skjaerven
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
- Norwegian Institute of Public Health; Bergen Norway
| | - AJ Wilcox
- Epidemiology Branch; NIEHS/NIH; Durham NC USA
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Herstad L, Klungsøyr K, Skjaerven R, Tanbo T, Forsén L, Åbyholm T, Vangen S. Maternal age and emergency operative deliveries at term: a population-based registry study among low-risk primiparous women. BJOG 2014; 122:1642-51. [PMID: 25100277 DOI: 10.1111/1471-0528.12962] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To study the association between maternal age and emergency operative delivery. The roles of in-labour indications, and birthweight ≥ 4000 g, gestational age ≥ 42 weeks, induction of labour, and epidural use, according to maternal age were explored. DESIGN Population-based study. SETTING Medical Birth Registry of Norway and Statistics Norway. POPULATION We studied 169 583 low-risk primiparous mothers with singleton, cephalic labours, at ≥37 weeks of gestation, from 1999 to 2009. METHODS The associations between maternal age and mode of delivery were analysed using multinomial regression analyses, adjusting for sociodemographic factors. MAIN OUTCOME MEASURES Emergency caesarean section and operative vaginal delivery. RESULTS Of women aged ≥40 years, 22% had emergency caesarean sections and 24% had operative vaginal deliveries, giving adjusted relative risk ratios (RRRs) of 6.60 (95% confidence interval, 95% CI 5.53-7.87) and 3.30 (95% CI 2.79-3.90), respectively, when compared with women aged 20-24 years. Adjustments for sociodemographic factors only slightly changed the estimates. Dystocia was the main indication, followed by fetal distress. All of the listed factors increased the level of emergency operative deliveries, mainly because of an increase in dystocia. The increase in risk for emergency caesarean section by all factors, and for operative vaginal deliveries by epidural, were greater in older than in younger women, but were significant for epidural only. CONCLUSIONS We found a close association between maternal age and emergency operative delivery in low-risk primiparas. Contributory factors increased the risk for both emergency operative delivery and epidural more in older than in younger women.
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Affiliation(s)
- L Herstad
- Women and Children's Division, Norwegian Resource Centre for Women's Health, Oslo University Hospital, Rikshospitalet, Norway
| | - K Klungsøyr
- Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - R Skjaerven
- Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - T Tanbo
- University of Oslo, Oslo, Norway.,Department of Gynaecology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - L Forsén
- Women and Children's Division, Norwegian Resource Centre for Women's Health, Oslo University Hospital, Rikshospitalet, Norway.,Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - T Åbyholm
- University of Oslo, Oslo, Norway.,Department of Obstetrics, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - S Vangen
- Women and Children's Division, Norwegian Resource Centre for Women's Health, Oslo University Hospital, Rikshospitalet, Norway.,Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
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Reyes-Bahamonde J, Raimann JG, Canaud B, Etter M, Kooman JP, Levin NW, Marcelli D, Marelli C, Power A, Van Der Sande FM, Thijssen S, Usvyat LA, Wang Y, Kotanko P, Blank PR, Szucs TD, Gibertoni D, Torroni S, Mandreoli M, Rucci P, Fantini MP, Santoro A, Van Der Veer SN, Nistor I, Bernaert P, Bolignano D, Brown EA, Covic A, Farrington K, Kooman J, Macias J, Mooney A, Van Munster BC, Van Den Noortgate N, Topinkova E, Wirnsberger G, Jager KJ, Van Biesen W, Stubnova V, Os I, Grundtvig M, Waldum B, Wu HY, Peng YS, Wu MS, Chu TS, Chien KL, Hung KY, Wu KD, Carrero JJ, Huang X, Sui X, Ruiz JR, Hirth V, Ortega FB, Blair SN, Coppolino G, Bolignano D, Rivoli L, Presta P, Mazza G, Fuiano G, Marx S, Petrilla A, Hengst N, Lee WC, Ruggajo P, Skrunes R, Svarstad E, Skjaerven R, Reisaether AV, Vikse BE, Fujii N, Hamano T, Akagi S, Watanabe T, Imai E, Nitta K, Akizawa T, Matsuo S, Makino H, Scalzotto E, Corradi V, Nalesso F, Zaglia T, Neri M, Martino F, Zanella M, Brendolan A, Mongillo M, Ronco C, Occelli F, Genin M, Deram A, Glowacki F, Cuny D, Mansurova I, Alchinbayev M, Malikh MA, Song S, Shin MJ, Rhee H, Yang BY, Kim I, Seong EY, Lee DW, Lee SB, Kwak IS, Isnard Bagnis C, Speyer E, Beauger D, Caille Y, Baudelot C, Mercier S, Jacquelinet C, Gentile SM, Briancon S, Yu TM, Li CY, Krivoshiev S, Borissova AM, Shinkov A, Svinarov D, Vlachov J, Koteva A, Dakovska L, Mihaylov G, Popov A, Polner K, Mucsi I, Braunitzer H, Kiss A, Nadasdi Z, Haris A, Zdrojewski L, Zdrojewski T, Rutkowski B, Minami S, Hesaka A, Yamaguchi S, Iwahashi E, Sakai S, Fujimoto T, Sasaki K, Fujita Y, Yokoyama K, Dey V, Farrah T, Traynor J, Spalding E, Robertson S, Geddes CC, Mann MC, Hobbs A, Hemmelgarn BR, Roberts D, Ahmed SB, Rabi D, Elewa U, Fernandez B, Alegre ER, Mahillo I, Egido J, Ortiz A, Marx S, Pomerantz D, Vietri J, Zewinger S, Speer T, Kleber ME, Scharnagl H, Woitas R, Pfahler K, Seiler S, Heine GH, Lepper PM, Marz W, Silbernagel G, Fliser D, Caldararu CD, Gliga ML, Tarta ID, Szanto A, Carlan O, Dogaru GA, Battaglia Y, Del Prete MA, De Gregorio MG, Errichiello C, Gisonni P, Russo L, Scognamiglio B, Storari A, Russo D, Kuma A, Serino R, Miyamoto T, Tamura M, Otsuji Y, Kung LF, Naito S, Iimori S, Okado T, Rai T, Uchida S, Sasaki S, Kang YU, Kim HY, Choi JS, Kim CS, Bae EH, Ma SK, Kim SW, Muthuppalaniappan VM, Byrne C, Sheaff M, Rajakariar R, Blunden M, Delmas Y, Loirat C, Muus P, Legendre C, Douglas K, Hourmant M, Herthelius M, Trivelli A, Goodship T, Bedrosian CL, Licht C, Marks A, Black C, Clark L, Prescott G, Robertson L, Simpson W, Simpson W, Fluck N, Wang SL, Hsu YH, Pai HC, Chang YM, Liu WH, Hsu CC, Shvetsov M, Nagaytseva S, Gerasimov A, Shalyagin Y, Ivanova E, Shilov E, Zhang Y, Zuo W, Marx S, Manthena S, Newmark J, Zdrojewski L, Rutkowski M, Zdrojewski T, Bandosz P, Gaciong Z, Solnica B, Rutkowski B, Wyrzykowski B, Ensergueix G, Karras A, Levi C, Chauvet S, Trivin C, Ficheux M, Augusto JF, Boudet R, Chambaraud T, Boudou-Rouquette P, Tubiana-Mathieu N, Aldigier JC, Jacquot C, Essig M, Thervet E, Oh YJ, Lee CS, Malho Guedes A, Silva AP, Goncalves C, Sampaio S, Morgado E, Santos V, Bernardo I, Leao Neves P, Onuigbo M, Agbasi N. CKD GENERAL AND CLINICAL EPIDEMIOLOGY 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Henningsen A, Wennerholm U, Gissler M, Romundstad L, Nygren K, Tiitinen A, Skjaerven R, Nyboe Andersen A, Lidegaard Ø, Forman J, Pinborg A. Risk of stillbirth and infant deaths after assisted reproductive technology: a Nordic study from the CoNARTaS† group. Hum Reprod 2014; 29:1090-6. [DOI: 10.1093/humrep/deu031] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Wennerholm UB, Henningsen AKA, Romundstad LB, Bergh C, Pinborg A, Skjaerven R, Forman J, Gissler M, Nygren KG, Tiitinen A. Perinatal outcomes of children born after frozen-thawed embryo transfer: a Nordic cohort study from the CoNARTaS group. Hum Reprod 2013; 28:2545-53. [DOI: 10.1093/humrep/det272] [Citation(s) in RCA: 254] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Dain L, Bider D, Levron J, Zinchenko V, Westler S, Dirnfeld M, Di Emidio G, Falone S, Vitti M, Santonocito M, Vento M, Artini PG, Di Pietro C, Amicarelli F, Tatone C, Herreboudt A, Colledge WH, Anastacio A, Pionneau C, Chardonnet S, Santos TA, Poirot C, Bensdorp AJ, Tjon-Kon-Fat RI, Koks C, Oosterhuis GJE, Hoek A, Hompes PGA, Broekmans FJ, Verhoeve HR, de Bruin JP, van Golde R, Repping S, Cohlen BJ, Mol BWJ, van der FV, van MW, Henningsen AA, Gissler M, Nygren KG, Skjaerven R, Tiitinen A, Wennerholm UB, Romundstad LB, Andersen AN, Lidegaard O, Forman JL, Pinborg A. Session 07: Female infertility: new developments. Hum Reprod 2013. [DOI: 10.1093/humrep/det229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Stora C, Devouche E, Delaroche L, Patrat C, Matheron S, Damond F, Yazbeck C, Longuet P, Llabador MA, Luton D, Epelboin S, Lemmen J, Rasmussen S, Ziebe S, El Khattabi L, Hafhouf E, Royere D, Pouly JL, De Mouzon J, Levy R, Hagman A, Loft A, Wennerholm UB, Pinborg A, Bergh C, Aittomaki K, Nygren KG, Romundstad LB, Hazekamp J, Soderstrom-Anttila V, Mukaida T, Goto T, Tajima T, Oka C, Takahashi K, Carrasco B, Boada M, Rodriguez I, Coroleu B, Barri PN, Veiga A, Wennerholm UB, Henningsen AKA, Romundstad LB, Bergh C, Pinborg A, Skjaerven R, Forman J, Gissler M, Nygren KG, Tiitinen A. Session 60: Perinatal outcome after ART. Hum Reprod 2013. [DOI: 10.1093/humrep/det193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sullivan E, Hilder L, Wang YA, Sundh KJ, Bergh C, Henningsen AKA, Kallen K, Romundstad LB, Pinborg A, Nyboe-Andersen A, Skjaerven R, Gissler M, Tiitinen A, Nygren KG, Wennerholm UB, Williams CL, Bunch KJK, Stiller CA, Murphy MFG, Wallce WH, Davies M, Botting B, Sutcliffe AG, Cesta CE, Olsson H, Cnattingius S, Nygren KG, Johansson V, Lichtenstein P, Iliadou AN, Gameiro S, van den Belt-Dusebout AW, Bleiker E, Braat D, van Leeuwen FE, Verhaak CM. Session 44: Long term outcome of ART. Hum Reprod 2013. [DOI: 10.1093/humrep/det177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fleten C, Nystad W, Stigum H, Skjaerven R, Lawlor DA, Davey Smith G, Naess O. Fleten et al. Respond to "Early Origins of Obesity". Am J Epidemiol 2012. [DOI: 10.1093/aje/kws132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Morken NH, Melve KK, Skjaerven R. Recurrence of prolonged and post-term gestational age across generations: maternal and paternal contribution. BJOG 2011; 118:1630-5. [DOI: 10.1111/j.1471-0528.2011.03154.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Whitworth KW, Baird DD, Stene LC, Skjaerven R, Longnecker MP. Fecundability among women with type 1 and type 2 diabetes in the Norwegian Mother and Child Cohort Study. Diabetologia 2011; 54:516-22. [PMID: 21170514 PMCID: PMC3650679 DOI: 10.1007/s00125-010-2003-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 11/12/2010] [Indexed: 10/18/2022]
Abstract
AIMS/HYPOTHESIS We assessed the effects of type 1 diabetes and type 2 diabetes on fecundability (as manifest by increased time-to-pregnancy [TTP]) in a large cohort of pregnant women. METHODS This study is based on the Norwegian Mother and Child Cohort Study. Members of this large cohort were enrolled early in pregnancy and asked about TTP and other factors. Among the 58,004 women included in the analysis, we identified 221 cases of type 1 diabetes and 88 cases of type 2 diabetes using the Medical Birth Registry of Norway. A logistic analogue of the proportional probability model, a Cox-like discrete-time model, was used to compute fecundability odds ratios (FORs) and 95% CI for type 1 diabetes and type 2 diabetes, adjusted for maternal age and prepregnancy BMI. RESULTS Compared with non-diabetic women, the adjusted FOR for women with type 1 diabetes was 0.76 (95% CI 0.64-0.89) and the adjusted FOR for women with type 2 diabetes was 0.64 (95% CI 0.48-0.84). These FORs did not change substantively and remained statistically significant after excluding women with irregular menstrual cycles and accounting for cycle length. CONCLUSIONS/INTERPRETATION The results from the present study provide evidence of substantially decreased fecundability for women with type 1 and type 2 diabetes, even among those with a normal menstrual cycle.
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Affiliation(s)
- K W Whitworth
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, P.O. Box 12233, Mail Drop A3-05, Durham, NC 27709, USA.
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Tandberg A, Melve KK, Nordtveit TI, Bjørge T, Skjaerven R. Maternal birth characteristics and perinatal mortality in twin offspring. An intergenerational population-based study in Norway, 1967-2008. BJOG 2011; 118:698-705. [DOI: 10.1111/j.1471-0528.2010.02877.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wang YA, Sullivan EA, Sullivan EA, Wang YA, Abeywardana S, Kovacs G, Henningsen AA, Wennerholm UB, Gissler M, Skjaerven R, Nyboe Andersen A, Nygren KG, Tiitinen A, Romundstad LB, Forman JL, Pinborg A, Fulford B, Bunting L, Tsibulsky I, Boivin J, Connolly M, Postma MJ, Crespi S, Nyboe Andersen A, Ziebe S, Druckenmiller S, Knopman JM, DeVore S, Krey L, Noyes N, Privitera L, Remohi J, Morgan M, Pellicer A, Garrido N. SELECTED ORAL COMMUNICATION SESSION, SESSION 73: EPIDEMIOLOGY & HEALTH ECONOMICS Wednesday 6 July 2011 14:00 - 15:45. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cupul-Uicab LA, Baird DD, Skjaerven R, Saha-Chaudhuri P, Haug K, Longnecker MP. In utero exposure to maternal smoking and women's risk of fetal loss in the Norwegian Mother and Child Cohort (MoBa). Hum Reprod 2010; 26:458-65. [PMID: 21147823 DOI: 10.1093/humrep/deq334] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Whether in utero exposure to tobacco smoke increases a woman's risk of fetal loss later in life is unknown, though data on childhood exposure suggest an association may exist. This study evaluated the association between in utero exposure to tobacco smoke and fetal loss in the Norwegian Mother and Child Cohort Study (MoBa), which enrolled ∼40% of the pregnant women in Norway from 1999 to 2008. METHODS Information on exposure to tobacco smoke in utero, the woman's own smoking behavior during pregnancy and other factors was obtained by a questionnaire completed at ∼17 weeks of gestation. Subsequent late miscarriage (fetal death <20 weeks) and stillbirth (fetal death ≥ 20 weeks) were ascertained from the Norwegian Medical Birth Registry. This analysis included 76 357 pregnancies (MoBa data set version 4.301) delivered by the end of 2008; 59 late miscarriages and 270 stillbirths occurred. Cox proportional hazards models were fit for each outcome and for all fetal deaths combined. RESULTS The adjusted hazard ratio (HR) of late miscarriage was 1.23 [95% confidence interval (CI), 0.72-2.12] in women with exposure to maternal tobacco smoke in utero when compared with non-exposed women. The corresponding adjusted HR for stillbirths was 1.11 (95% CI, 0.85-1.44) and for all fetal deaths combined, it was 1.12 (95% CI, 0.89-1.43). CONCLUSIONS The relatively wide CI around the HR for miscarriage reflected the limited power to detect an association, due to enrollment around 17 weeks of gestation. However, for in utero exposure to tobacco smoke and risk of stillbirth later in life, where the study power was adequate, our data provided little support for an association.
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Affiliation(s)
- L A Cupul-Uicab
- Epidemiology Branch, National Institute of Environmental Health Sciences NIH/DHHS/USA, MD A3-05, 111 TW Alexander Dr, Research Triangle Park, NC 27709, USA.
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Wang YA, Kovacs G, Sullivan EA, Sullivan EA, Wang YA, Scotland G, Mclernon D, Kurinczuk JJ, Jamieson M, Lyall H, Rajkhowa M, Harrold A, Bhattacharya S, Romundstad LB, Vatten LJ, Sunde A, During VV, Skjaerven R, Romundstad PR, Norgaard L, Bergholt T, Pinborg A. Session 20: Single Embryo Transfer & Art Pregnancy. Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tandberg A, Bjørge T, Nygård O, Børdahl PE, Skjaerven R. Trends in incidence and mortality for triplets in Norway 1967-2006: the influence of assisted reproductive technologies. BJOG 2010; 117:667-75. [DOI: 10.1111/j.1471-0528.2010.02530.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Romundstad LB, Romundstad PR, Sunde A, von During V, Skjaerven R, Vatten LJ. Assisted fertilization and breech delivery: risks and obstetric management. Hum Reprod 2009; 24:3205-10. [DOI: 10.1093/humrep/dep301] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Nyland H, Naess A, Skjaerven R. Natural history and prognosis of acute Guillain-Barré syndrome; A follow-up study of 160 cases in Western Norway. Acta Neurol Scand 2009. [DOI: 10.1111/j.1600-0404.1984.tb02450.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Magelssen H, Melve KK, Skjaerven R, Fosså SD. Parenthood probability and pregnancy outcome in patients with a cancer diagnosis during adolescence and young adulthood. Hum Reprod 2007; 23:178-86. [PMID: 18024486 DOI: 10.1093/humrep/dem362] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To compare first-time parenthood probability and pregnancy outcome between cancer patients and the general population. METHODS Data from a hospital registry on cancer patients aged 15-35 years at diagnosis, including date/type of diagnosis, treatment and date of death, were merged with data from the Cancer Registry and the Medical Birth Registry, providing date of childbirth, IVF, pregnancy outcomes and demographics. RESULTS The first-time parenthood probability at the age of 35 years was 63% in male patients (n = 463) and 64% in the male general population (n = 367 068). Figures in female patients were 66% (n = 284) compared with 79% in the female general population (n = 349 576) (P = 0.007). A total of 487 male and 251 female cancer patients were childless pre-diagnosis, and 130 male and 104 female cancer patients had one child before diagnosis and at least one birth post-diagnosis. Congenital anomalies were more frequent in first-borns to previously childless male patients [adjusted odds ratio (OR(adj)): 1.5; 95% confidence interval (CI): 1.1-2.3]. The risk of low birth weight and preterm delivery after cancer was increased in infants born to female patients, as was perinatal mortality (OR(adj) 2.3; 95% CI: 1.1-5.0) among post-diagnosis first births. CONCLUSIONS The first-time parenthood probability in 35-year old cancer patients is approximately 60%, which in female patients is significantly reduced compared with the general population. Post-diagnosis pregnancies to female patients are high-risk pregnancies.
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Affiliation(s)
- H Magelssen
- Rikshospitalet-Radiumhospitalet Medical Center, Department of Clinical Cancer Research, University of Oslo, Montebello, 0310 Oslo, Norway.
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Dahl J, Myhr KM, Daltveit AK, Skjaerven R, Gilhus NE. Is smoking an extra hazard in pregnant MS women? Findings from a population-based registry in Norway. Eur J Neurol 2007; 14:1113-7. [PMID: 17880567 DOI: 10.1111/j.1468-1331.2007.01913.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Multiple sclerosis (MS) in women leads to increased risk of operative delivery and reduced birth weight, which are presumably related to the neurological dysfunction in this patient group. Lifestyle factors may also contribute, and we therefore investigated smoking habits and relevant social factors in pregnant MS women. In total, 372,128 births were registered in the compulsory Medical Birth Registry of Norway from December 1, 1998 to October 6, 2005, and of them 250 by MS mothers. The MS births were compared with all the non-MS births. Smoking during pregnancy was not increased in the MS group compared with the non-MS references. From 1998 to 2005 the MS group had a larger reduction in smoking rate during pregnancy than the reference group. The differences in pregnancy and birth outcome between smokers and non-smokers were similar in the MS and the reference group. Those in the smoking MS group had no increase in birth complications, operative interventions or negative birth outcome compared with those in the smoking reference group. Smoking during pregnancy did not explain the birth weight reduction found for newborns of MS mothers.
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Affiliation(s)
- J Dahl
- Section of Neurology, Department of Clinical Medicine, University of Bergen, Bergen, Norway.
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Abstract
OBJECTIVE To produce population-based, gender- and gestational-age-specific centile curves for placental weight. DESIGN Population study. SETTING Medical Birth Registry of Norway. POPULATION All singleton live births in Norway from 1 January 1999 to 31 December 2002. METHODS In a cohort of children born in Norway, placental weights and the ratio of the birthweight to the placental weight were analysed to produce percentile curves. MAIN OUTCOME MEASURES Placental weight, birthweight-to-placental weight ratio. RESULTS Tables and figures are presented for placental percentiles curves according to gestational age and gender. Also, tables and figures are presented for the ratio of birthweight to placental weight. CONCLUSIONS To our knowledge, this is the first time that population percentile curves have been produced for placental weights and hence for the ratio of birthweight to placental weight. These percentile curves may act as a reference for other populations as well until population-specific curves can be produced.
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Affiliation(s)
- J M D Thompson
- Department of Paediatrics, University of Auckland, Auckland, New Zealand.
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Basso O, Rasmussen S, Weinberg C, Wilcox A, Irgens L, Skjaerven R. Time Trends in Fetal and Infant Survival in Babies of Preeclamptic Pregnancies. Norway, 1967–2003. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s236-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hill SAR, Hjelmeland B, Johannessen NM, Irgens LM, Skjaerven R. Changes in parental risk behaviour after an information campaign against sudden infant death syndrome (SIDS) in Norway. Acta Paediatr 2004; 93:250-4. [PMID: 15046283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
AIM To assess parental risk behaviour before and after a sudden infant death syndrome (SIDS) information campaign with special emphasis on associations with maternal age, education, marital status and birth order. METHODS Data from questionnaires sent to all mothers who gave birth in Norway during a period before the campaign were compared with corresponding data obtained after the campaign. RESULTS Prevalence of non-supine sleeping position decreased from 33.7% to 13.6% while changes in smoking, non-breastfeeding and co-sleeping were disappointing. Risk factors were particularly prevalent in young mothers, but also in mothers with a minimum period of education, non-cohabitation and at birth order 2+. CONCLUSIONS Non-supine sleeping decreased to a level that has never been reported before. In future campaigns, subgroup-specific measures may be needed.
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Daltveit AK, Irgens LM, Oyen N, Skjaerven R, Markestad T, Wennergren G. Circadian variations in sudden infant death syndrome: associations with maternal smoking, sleeping position and infections. The Nordic Epidemiological SIDS Study. Acta Paediatr 2003; 92:1007-13. [PMID: 14599060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
AIM To study circadian variation in the sudden infant death syndrome (SIDS) and possible associations with risk factors for SIDS. METHODS A questionnaire-based case-control study matched for place of birth, age and gender was conducted in Denmark, Norway and Sweden: The Nordic Epidemiological SIDS Study. The study comprised 244 SIDS victims and 869 control infants between September 1992 and August 1995. The main outcome was hour found dead. RESULTS A significant circadian pattern was observed among the 242 SIDS victims with a known hour found dead, with a peak at 08.00-08.59 in the morning (n = 33). Of the SIDS victims, 12% were found dead at 00.00-05.59, 58% at 06.00-11.59, 21% at 12.00-17.59 and 9.0% at 18.00-23.59. When comparing night/morning SIDS and day/evening SIDS (found dead 00.00-11.59 and 12.00-23.59, respectively), the proportion of night/morning SIDS was high among infants of smoking mothers (81% vs 53%, p < 0.001), infants with a reported cold (82% vs 64%, p = 0.007) and infants sleeping side/supine (81% vs 60%, p < 0.001). No associations were observed between hour found dead and other sociodemographic risk factors for SIDS. Risk (odds ratio and 95% confidence interval) of night/morning SIDS and day/evening SIDS was 7.0 (4.5-10.9) and 1.5 (0.8-2.5), respectively, for maternal smoking, 2.2 (1.5-3.1) and 0.6 (0.3-1.3), respectively, if the infant had a reported cold, 3.7 (2.1-6.6) and 3.1 (1.1-8.4), respectively, if the infant was put to sleep in the side position (supine reference), and 11.0 (5.9-20.2) and 21.6 (7.6-60.8), respectively, if the infant was put to sleep in the prone position. CONCLUSION The observed higher proportion of night/morning cases in SIDS if the mother smoked, if the infant was reported to have a cold and if the infant was sleeping side/supine may contribute to the understanding of some epidemiological characteristics of SIDS.
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Affiliation(s)
- A K Daltveit
- Medical Birth Registry of Norway, Bergen, Norway.
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Abstract
AIM To assess the effect of vitamin supplementation on the risk of sudden infant death syndrome (SIDS). METHODS The analyses are based on data from the Nordic Epidemiological SIDS Study, a case-control study in which parents of SIDS victims in the Scandinavian countries were invited to participate together with parents of four matched controls between 1 September 1992 and 31 August 1995. The odds ratios presented are computed by conditional logistic regression analysis. RESULTS The crude odds ratio in Scandinavia for not giving vitamin substitution was 2.8 (95% CI (1.9, 4.3)). This effect was statistically significant in Norway and Sweden, which use A and D vitamin supplementation, but not in Denmark, where only vitamin D supplementation is given. The odds ratios remained significant in Sweden when an adjustment was made for confounding factors (OR 28.4, 95% CI (4.7, 171.3)). CONCLUSION We found an association between increased risk of sudden infant death syndrome and infants not being given vitamin supplementation during their first year of life. This was highly significant in Sweden, and the effect is possibly connected with vitamin A deficiency. This effect persisted when an adjustment was made for potential confounders, includingsocioeconomic factors.
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Affiliation(s)
- B Alm
- Department of Paediatrics, Institute for the Health of Women and Children, Queen Silvia Children's Hospital, Göteborg, Sweden.
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Vatten LJ, Romundstad PR, Trichopoulos D, Skjaerven R. Pre-eclampsia in pregnancy and subsequent risk for breast cancer. Br J Cancer 2002; 87:971-3. [PMID: 12434286 PMCID: PMC2364313 DOI: 10.1038/sj.bjc.6600581] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2002] [Revised: 08/02/2002] [Accepted: 08/07/2002] [Indexed: 11/08/2022] Open
Abstract
Women who experience pre-eclampsia or hypertension during pregnancy may have a reduced risk for breast cancer later in life. The evidence is based on case-control studies, and here we report the results of a cohort study exploring the link between pre-eclampsia and gestational hypertension diagnosed in the first pregnancy and subsequent risk for breast cancer. We combined information from the Medical Birth Registry and the Cancer Registry in Norway, which are both nation-wide. Between 1967, when the birth registry was established, and 1998, 694 657 women were recorded with a first birth, and classified according to whether pre-eclampsia and/or hypertension was diagnosed in the first pregnancy. Linkage to the Norwegian Cancer Registry identified 5474 new cases of breast cancer diagnosed subsequently to their first delivery. Compared to other parous women, women with pre-eclampsia and/or hypertension diagnosed in their first pregnancy had 19% lower risk (95% confidence interval, 9 to 29%) for breast cancer, after adjustment for attained age, calendar period of diagnosis, age at first birth, and parity. This result was similar for term and preterm deliveries, across the range of offspring birth weight, and for pre- and postmenopausal women. These results suggest that the pathophysiology surrounding pre-eclampsia and gestational hypertension plays an important role in breast cancer etiology. A better understanding of the underlying processes could provide an insight into the pathogenesis of breast cancer.
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Affiliation(s)
- L J Vatten
- Department of Community Medicine and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
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Vatten LJ, Romundstad PR, Trichopoulos D, Skjaerven R. Pregnancy related protection against breast cancer depends on length of gestation. Br J Cancer 2002; 87:289-90. [PMID: 12177796 PMCID: PMC2364219 DOI: 10.1038/sj.bjc.6600453] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2002] [Accepted: 05/08/2002] [Indexed: 11/25/2022] Open
Abstract
In a prospective study of 694 657 parous women in Norway, 5474 developed breast cancer after their first birth. If the first pregnancy lasted less than 32 weeks, the risk was 22% (95% confidence interval, -3% to 53%) less than after a pregnancy of 40 weeks or more, with a significant declining trend in risk (P for trend=0.02).
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Affiliation(s)
- L J Vatten
- Department of Community Medicine and General Practice, The Norwegian University of Science and Technology, Trondheim, Norway.
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Alm B, Wennergren G, Norvenius SG, Skjaerven R, Lagercrantz H, Helweg-Larsen K, Irgens LM. Breast feeding and the sudden infant death syndrome in Scandinavia, 1992-95. Arch Dis Child 2002; 86:400-2. [PMID: 12023166 PMCID: PMC1762985 DOI: 10.1136/adc.86.6.400] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To assess the effects of breast feeding habits on sudden infant death syndrome (SIDS). METHODS The analyses are based on data from the Nordic Epidemiological SIDS Study, a case-control study in which parents of SIDS victims in the Scandinavian countries between 1 September 1992 and 31 August 1995 were invited to participate, each with parents of four matched controls. The odds ratios presented were computed by conditional logistic regression analysis. RESULTS After adjustment for smoking during pregnancy, paternal employment, sleeping position, and age of the infant, the adjusted odds ratio (95% CI) was 5.1 (2.3 to 11.2) if the infant was exclusively breast fed for less than four weeks, 3.7 (1.6 to 8.4) for 4-7 weeks, 1.6 (0.7 to 3.6) for 8-11 weeks, and 2.8 (1.2 to 6.8) for 12-15 weeks, with exclusive breast feeding over 16 weeks as the reference. Mixed feeding in the first week post partum did not increase the risk. CONCLUSIONS The study is supportive of a weak relation between breast feeding and SIDS reduction.
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Affiliation(s)
- B Alm
- Department of Paediatrics, Queen Silvia Children's Hospital, Göteborg Department of Paediatrics, Karolinska Hospital, Stockholm, Sweden.
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Abstract
STUDY OBJECTIVE Understanding causes of variation in birth weight has been limited by lack of sufficient sets of data that include paternal birth weight. The objective was to estimate risks of low birth weight dependent on parental birth weights and to estimate father-mother-offspring correlations for birth weight to explain the variability in birth weight in terms of effects of genes and environmental factors. DESIGN A family design, using trios of father-mother-firstborn child. SETTING The complete birth population in Norway 1967-98. PARTICIPANTS 67 795 families. MAIN RESULTS The birth weight correlations were 0.226 for mother-child and 0.126 for father-child. The spousal correlation was low, 0.020. The relative risk of low birth weight in the first born child was 8.2 if both parents were low birth weight themselves, with both parents being above 4 kg as the reference. The estimate of heritability is about 0.25 for birth weight, under the assumption that cultural transmission on the paternal side has no effect on offspring prenatal growth. CONCLUSIONS Paternal birth weight is a significant and independent predictor of low birth weight in offspring. The estimate of the heritability of birth weight in this study is lower than previously estimated from data within one generation in the Norwegian population.
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Affiliation(s)
- P Magnus
- Department of Population Health Sciences, National Institute of Public Health, Oslo, Norway.
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Maehle BO, Tretli S, Skjaerven R, Thorsen T. Premorbid body weight and its relations to primary tumour diameter in breast cancer patients; its dependence on estrogen and progesteron receptor status. Breast Cancer Res Treat 2001; 68:159-69. [PMID: 11688519 DOI: 10.1023/a:1011977118921] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Hormonal mechanisms have been offered as an explanation for the higher frequency of large tumours, lymph node metastases and poorer prognosis in obese breast cancer patients than in lean ones. If hormonal mechanisms are important for these relations, they should probably act more strongly in patients with hormonal receptor positive tumours than in those with negative ones. We have examined if the relations between premorbid body weight or Quetelet's index (weight/height2) and tumour diameter are modified by estrogen receptor alpha (ER) and progesteron receptor (PgR) status. The analyses were based on 1,241 women with unilateral disease treated with modified radical mastectomy living in the geografic area of Haukeland Hospital. Their body weight and height have been measured as a mean 12.5 years before presentation of the disease. Body weight and Quetelet's index have been adjusted for age. The relations were studied using linear regression analyses adjusting the effect of body weight with height and mean nuclear area of the tumour cells and adjusting the effect of Quetelet's index for mean nuclear area. The main findings showed that patients with high body weight or Quetelet's index presented more often with PgR positive tumours than lean ones. Quetelet's index was also positively related to ER. These relations were present in patients older than 50 years of age (older). Patients with large tumours (>2.0 cm) had significantly higher body weight and Quetelet's index than those with small ones. These differences were significantly present in older patients and in patients with PgR negative and ER negative-PgR negative tumours. Linear regression analyses confirmed that tumour diameter increases with body weight and Quetelet's index. These relations were present in both lymph node groups and in older patients. Stratification according to hormonal receptor status showed these relations to be significant in patients with ER negative, with PgR negative and those with ER negative-PgR negative tumours only. Taking age and hormonal receptor status into consideration simultaneously, both body weight and Quetelet's index were significantly related to tumour diameter in older patients with hormone receptor negative tumours. In conclusion body size was positively related to hormone receptor status and to diameter of the primary tumour. The relation to tumour diameter was present in older patients with hormone receptor negative tumours. Although hormonal mechanisms able to act on the tumour can not be excluded, mechanisms acting independent of hormonal receptors must be considered. Different mechanisms related to body fat cytokines are discussed.
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Affiliation(s)
- B O Maehle
- The Gade Institute, Department of Pathology, Oslo, Norway
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Abstract
CONTEXT Few systematic data exist on survival and reproduction among males with birth defects and their contribution to occurrence of birth defects in the next generation. OBJECTIVE To estimate survival of males with registered birth defects, their subsequent reproduction rates, and their risk of transmitting birth defects to their offspring. DESIGN AND SETTING Population-based cohort study of data from the Medical Birth Registry of Norway. SUBJECTS A total of 486 207 males born in Norway between 1967 and 1982, 12 292 of whom had a recorded birth defect. MAIN OUTCOME MEASURES Survival rates through 1992, reproduction rates through 1998, and risk of birth defects among offspring of males with vs without birth defects. RESULTS Survival through 1992 was lower among males with birth defects (84% vs 97%). Compared with males without birth defects, affected males were 28% less likely to have had a child. Among offspring of affected males, 5.1% had a registered birth defect compared with 2.1% of offspring of males without birth defects (relative risk [RR], 2.4; 95% confidence interval [CI], 1.9-3.0). Offspring of affected fathers had an increased risk of the same defect as their fathers (RR, 6.5; 95% CI, 4.0-10.4) and an increased risk of dissimilar defects (RR, 1.8; 95% CI, 1.3-2.5). CONCLUSIONS Compared with unaffected males, males with birth defects have higher mortality and survivors are less likely to have a child. Fathers with birth defects are significantly more likely than unaffected fathers to have an affected child.
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Affiliation(s)
- R T Lie
- Section for Medical Statistics, University of Bergen, Armauer Hansens Bldg, 5021 Bergen, Norway.
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37
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Alm B, Norvenius SG, Wennergren G, Skjaerven R, Øyen N, Milerad J, Wennborg M, Kjaerbeck J, Helweg-Larsen K, Irgens LM. Changes in the epidemiology of sudden infant death syndrome in Sweden 1973-1996. Arch Dis Child 2001; 84:24-30. [PMID: 11124779 PMCID: PMC1718623 DOI: 10.1136/adc.84.1.24] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND From the early 1970s to the early 1990s, there was a significant rise in the incidence of sudden infant death syndrome (SIDS) in Scandinavia. Following the risk reducing campaign, the incidence has fallen to about the same level as in 1973. AIMS To identify the changes that have occurred in the epidemiology of SIDS. METHODS We compared the Swedish part of the Nordic Epidemiological SIDS Study (NESS), covering the years 1992-1995, with two earlier, descriptive studies during this period. To assess the changing effects of risk factors, we analysed data from the Medical Birth Registry of Sweden, covering the years 1973-1996. RESULTS There was a predominance of deaths during weekends in the 1970s and 1990s. The seasonal variation was most notable in the 1980s. The proportion of young mothers decreased from 14% to 5%. Cohabitation (living with the biological father) was as frequent in the 1990s as in the 1970s. The prevalence of high parity, admissions to neonatal wards, low birth weight, prematurity, and multiple pregnancies were all increased in the 1990s compared to the 1970s. No significant change in the prevalence of previous apparent life threatening events was found. Deaths occurring in cars diminished from 10% to below 2%. In the data from the Medical Birth Registry of Sweden, there were significantly increased odds ratios after the risk reducing campaign of the risk factors smoking during early pregnancy and preterm birth. We could find no increased effects of maternal age, parity, or being small for gestational age over time. The rate of deaths at weekends remained increased; the median age at death fell from 90 to 60 days. Seasonal variation was less notable in the periods of low incidence.
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Affiliation(s)
- B Alm
- Department of Paediatrics, Institute for the Health of Women and Children, Göteborg University, The Queen Silvia Children's Hospital, SE-416 85 Göteborg, Sweden.
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38
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Affiliation(s)
- G M Egeland
- Locus for Registry-based Epidemiology, Department of Public Health and Primary Health Care, University of Bergen, N-5021 Bergen, Norway.
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39
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Abstract
OBJECTIVE This study was undertaken to provide new standards for birth weight according to gestational age through the addition of family data on maternal birth weight and birth weights of previous siblings. STUDY DESIGN The analyses were based on 1.7 million births in Norway from 1967 through 1998. These population data were arranged into sibships and mother-offspring units through unique personal numbers. We categorized first births by sex and maternal birth weight and second births by sex and birth weight of the older sibling. RESULTS Standards for birth weight per gestational age percentiles differed by >1100 g when the birth weight of an older sibling was considered and by almost 700 g when maternal birth weight was considered. The value of these new standards for birth weight according to gestational age was demonstrated through variation in perinatal mortality. CONCLUSION Maternal birth weight and birth weights of previous siblings allow improved predictions of birth weight according to gestational age and should be used for classification of small-for-gestational-age births.
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Affiliation(s)
- R Skjaerven
- Section for Medical Statistics and the Medical Birth Registry of Norway, University of Bergen, Bergen, Norway
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40
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Abstract
Data from the Medical Birth Registry of Norway were used to estimate sibship correlations in large sibships (each with > or = 5 infants among singleton live births surviving the first year of life), while adjusting for covariates such as infant gender, gestational age, maternal age, parity, and time since last pregnancy. This sample of 12,356 full sibs in 2,462 sibships born in Norway between 1968 and 1989 was selected to maximize the information on parity, and a robust approach to estimating both regression coefficients and the sibship correlation using generalized estimating equations (GEE) was employed. In concordance with previous studies, these data showed a high overall correlation in birth weight among full sibs (0.48 +/- 0.01), but this sibship correlation was influenced by parity. In particular, the correlation between the firstborn infant and a subsequent infant was slightly lower than between two subsequent sibs (0.44 +/- 0.01 vs. 0.50 +/- 0.01, respectively). The effect of time between pregnancies was statistically significant, but its predicted impact was modest over the period in which most of these large families were completed. While these data cannot discriminate whether factors influencing birth weight are maternal or fetal in nature, this analysis does illustrate how robust statistical models can be used to estimate sibship correlations while adjusting for covariates in family studies.
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Affiliation(s)
- T H Beaty
- Department of Epidemiology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA
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41
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Haug K, Irgens LM, Skjaerven R, Markestad T, Baste V, Schreuder P. Maternal smoking and birthweight: effect modification of period, maternal age and paternal smoking. Acta Obstet Gynecol Scand 2000; 79:485-9. [PMID: 10857873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVE To study the effect on birthweight of maternal smoking, and its modification by study period, maternal age and paternal smoking. DESIGN A retrospective questionnaire based national survey comprising a random sample (n=34,799) of all mothers giving birth in Norway 1970-91. Variables studied were parental smoking during pregnancy, birthweight, maternal age and infant's year of birth. RESULTS The overall difference in mean birthweight between non-smoking and smoking mothers was 197 g. The difference in birthweight between non-smoking and smoking mothers increased with maternal age from 182 g (<20 years of age) to 232 g (35+ years of age). There was no significant effect of paternal smoking on birthweight when the mother was a non-smoker. When the mother was a smoker and the father was a non-smoker, the birthweight, adjusted for maternal age, was reduced by 153 g (p<0.005). However, when both parents smoked, the birthweight, adjusted for maternal age, was reduced by 201 g (p<0.0005). Even though the prevalence of paternal smoking decreased by 38% during the study period, there was no significant increase in overall mean birthweight. IMPLICATION AND RELEVANCE OF RESULTS: The negative effect of maternal smoking on birthweight appears to increase with maternal age. For a non-smoking pregnant woman to live with a smoking partner has little, if any, effect on birthweight. The negative effect of paternal smoking was only observed when the mother was smoking and might reflect two possible mechanisms: (1) that a smoking mother has a greater cigarette consumption when the partner also smokes, and (2) that a smoking mother is less concerned about passive smoking than a non-smoking mother.
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Affiliation(s)
- K Haug
- Department of Public Health and Primary Health Care, University of Bergen, Norway
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42
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Skjaerven R, Gjessing HK, Bakketeig LS. Birthweight by gestational age in Norway. Acta Obstet Gynecol Scand 2000; 79:440-9. [PMID: 10857867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVE To describe birthweight by gestational age in Norway for the period 1967-1998, evaluate secular trends and provide new standards for small for gestational age for 16 to 44 weeks of gestation. SUBJECTS AND METHODS The analyses were based on more than 1.8 million singleton births, covering all births in Norway for a 32 year period. Percentiles for birthweight by gestational age were estimated using smoothed means and standard deviations. In the preterm weeks, means and standard deviations were carefully screened for birthweight-gestational age consistency, adapting a method of Wilcox and Russell. Differences in birthweight by gestational age for stillbirths and livebirths in extremely preterm weeks (16-28) are presented, and the effects of cesarean section are evaluated. We observed a clear increase in birthweight by gestational age for all term weeks, but a decrease for most of the preterm weeks over the same period. This decrease was related to the increase in deliveries by cesarean section. CONCLUSIONS Percentiles for birthweight by gestational age are presented for clinical use, based on a current period 1987-98, covering 20-44 completed gestational weeks. In the final standards we excluded stillbirths, infants born with malformations and cesarean sections. Birthweights in the Scandinavian populations are high and standards from other populations may not be representative, especially for the term weeks. Also, the secular changes demonstrated in this study indicate that old birthweight by gestational age standards need revision, especially due to changes in obstetrical routines influencing preterm data.
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Affiliation(s)
- R Skjaerven
- Section for Medical Statistics, and the Medical Birth Registry of Norway, Locus of Registry-based Epidemiology, University of Bergen
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43
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Glinianaia SV, Skjaerven R, Magnus P. Birthweight percentiles by gestational age in multiple births. A population-based study of Norwegian twins and triplets. Acta Obstet Gynecol Scand 2000; 79:450-8. [PMID: 10857868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVE To assess secular trends for birthweight by gestational age in twins in Norway and to develop current national birthweight standards by gestational age for twin and triplet births using population-based data. MATERIAL AND METHODS The analysis of secular trends for birthweight and gestational age in twins was based on 32,379 twin livebirths (1967-95). Taking into account the observed secular trends in birthweight for 35-40 weeks of gestation, data on twins born during 1987-95 only were included in the calculation of birthweight percentiles for 35-40 weeks, while for lower and upper weeks, data on twins born during 1967-95 were used. The construction of birthweight-for-gestation curves for triplets was based on the data on 690 triplets. RESULTS Whereas the overall mean birthweight and gestational age decreased in 1987-95 compared with the previous years, the mean birthweights by gestational age for the 35-40 weeks of gestation was significantly higher in 1987-95. Male twins weighed more than female twins throughout the gestation with consistent and significant differences from 27 to 42 weeks of gestation. Smoothed curves for birthweight-by-gestational-age percentiles of male and female twins are plotted. The birthweight-by-gestational-age curves of triplets were almost identical with twin curves before 30 weeks of gestation, starting to diverge from them progressively thereafter. The intrauterine growth of twin births also starts to differ markedly from singletons at approximately 30 weeks of gestation. CONCLUSION This study shows that plurality-specific birthweight-by-gestation standards should be used for assessment of fetal growth in multiple births rather than singleton standards.
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Affiliation(s)
- S V Glinianaia
- Department of Population Health Sciences, National Institute of Public Health, Oslo, Norway
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Melve KK, Gjessing HK, Skjaerven R, Oyen N. Infants' length at birth: an independent effect on perinatal mortality. Acta Obstet Gynecol Scand 2000; 79:459-64. [PMID: 10857869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
AIM To investigate whether variations in birth length (crown-heel-length) were associated with perinatal mortality rate independent of birth weight. MATERIAL The study population was singleton live- and stillbirths from 16 weeks of gestation compiled in the Medical Birth Registry of Norway from 1967 to 1997, totaling 1,705,652 births. METHOD The total population was analyzed using z-scores for length at birth, birth weight and gestational age. Variation in perinatal mortality by length at birth was studied within birth weight strata (250 g) by logistic regression. RESULTS Perinatal mortality varied more by birth length than by birth weight or gestational age, especially for values above the population means. Within birth weight strata, the association between perinatal mortality and length was similar in all 250 g birth weight categories above 1,500 grams: mortality was lowest at birth lengths 0-2 cm below average, with mortality rates increasing exponentially in either direction. CONCLUSION Within all birth weight strata, and adjusted for gestational age, long infants had the higher risk of perinatal death, suggesting that length at birth may be a valuable predictor when assessing the risk of perinatal mortality.
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Affiliation(s)
- K K Melve
- Section for Medical Statistics, Locus of Registry-based Epidemiology, University of Bergen, Norway
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45
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Abstract
The authors studied the extent to which preterm birth and perinatal mortality are dependent on the gestational ages of previous births within sibships. The study was based on data collected by the Medical Birth Registry of Norway from 1967 to 1995. Newborns were linked to their mothers through Norway's unique personal identification number, yielding 429,554 pairs of mothers and first and second singleton newborns with gestational ages of 22-46 weeks, based on menstrual dates. Siblings' gestational ages were significantly correlated (r = 0.26). The risk of having a preterm second birth was nearly 10 times higher among mothers whose firstborn child had been delivered before 32 weeks' gestation than among mothers whose first child had been born at 40 weeks. However, perinatal mortality in preterm second births was significantly higher among mothers whose first infant had been born at term, compared with mothers whose firstborn child was delivered at 32-37 weeks. Since perinatal mortality among preterm infants is dependent on the gestational age in the mother's previous birth, a common threshold of 37 weeks' gestation for defining preterm birth as a risk factor for perinatal death may not be appropriate for all births to all mothers.
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Affiliation(s)
- K K Melve
- Department of Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Norway
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46
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Alm B, Wennergren G, Norvenius G, Skjaerven R, Oyen N, Helweg-Larsen K, Lagercrantz H, Irgens LM. Caffeine and alcohol as risk factors for sudden infant death syndrome. Nordic Epidemiological SIDS Study. Arch Dis Child 1999; 81:107-11. [PMID: 10490513 PMCID: PMC1718018 DOI: 10.1136/adc.81.2.107] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess whether alcohol and caffeine are independent risk factors for sudden infant death syndrome (SIDS). MATERIALS AND METHODS Analyses based on data from the Nordic epidemiological SIDS study, a case control study in which all parents of SIDS victims in the Nordic countries from 1 September 1992 to 31 August 1995 were invited to participate with parents of four controls, matched for sex and age at death. Odds ratios (ORs) were calculated by conditional logistic regression analysis. RESULTS The crude ORs for caffeine consumption > 800 mg/24 hours both during and after pregnancy were significantly raised: 3.9 (95% confidence interval (CI), 1.9 to 8.1) and 3.1 (95% CI, 1.5 to 6.3), respectively. However, after adjustment for maternal smoking in 1st trimester, maternal age, education and parity, no significant effect of caffeine during or after pregnancy remained. For maternal or paternal alcohol use, no significant risk increase was found after adjusting for social variables, except for heavy postnatal intake of alcohol by the mother, where the risk was significantly increased. CONCLUSIONS Caffeine during or after pregnancy was not found to be an independent risk factor for SIDS after adjustment for maternal age, education, parity, and smoking during pregnancy. Heavy postnatal but not prenatal intake of alcohol by the mother increased the risk.
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Affiliation(s)
- B Alm
- Department of Paediatrics, Sahlgrenska University Hospital/Ostra, S-416 85 Göteborg, Sweden
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Daltveit AK, Vollset SE, Skjaerven R, Irgens LM. Impact of multiple births and elective deliveries on the trends in low birth weight in Norway, 1967-1995. Am J Epidemiol 1999; 149:1128-33. [PMID: 10369507 DOI: 10.1093/oxfordjournals.aje.a009767] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To describe trends in low birth weight (less than 2,500 g), the authors analyzed 1.7 million live births and stillbirths registered between 1967 and 1995 in the Medical Birth Registry of Norway. The proportion of low birth weight infants declined from 5.3% in 1967 to 4.5% in 1979 and was followed by a steady increase that reached 5.3% in 1995. Similar trends were observed in the proportion of preterm births. Mean birth weight increased from 3,456 g in 1967 to 3,518 g in 1995. From 1979 to 1987, the increase in the prevalence of low birth weight was related to single births, and after 1987 it was related to multiple births, which increased from 2.3% of all births in 1987 to 3.1% in 1995. The proportion of low birth weight in births occurring after 37 weeks of gestation declined continuously, resulting in low birth weight births' to an increasing extent being made up of births occurring before 37 weeks of gestation. In an ecologic analysis based on county of maternal residence, the increase in low birth weight among single births was accounted for by an increase in deliveries with induction of labor or cesarean section. The authors conclude that the overall proportion of low birth weight births is not a good indicator of health in a population with extensive use of obstetric procedures that affect gestational age or assisted fertilization, which increases the number of multiple births.
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Affiliation(s)
- A K Daltveit
- Medical Birth Registry of Norway, University of Bergen
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48
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Helweg-Larsen K, Lundemose JB, Oyen N, Skjaerven R, Alm B, Wennergren G, Markestad T, Irgens LM. Interactions of infectious symptoms and modifiable risk factors in sudden infant death syndrome. The Nordic Epidemiological SIDS study. Acta Paediatr 1999; 88:521-7. [PMID: 10426174 DOI: 10.1080/08035259950169521] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
The aim of the study was to investigate the effect of infection on sudden infant death syndrome (SIDS) and to analyse whether modifiable risk factors of SIDS, prone sleeping, covered head and smoking act as effect modifiers. In a consecutive multicentre case-control study of SIDS in Denmark, Norway and Sweden, questionnaires on potential risk factors for SIDS were completed by parents of SIDS victims, and for at least two controls matched for gender, age and place of birth. All SIDS cases were verified by an autopsy. The study comprised 244 SIDS cases and 869 controls, analysed by conditional logistic regression. Significantly more cases than controls presenting symptoms of infectious diseases during the last week and/or last day were treated with antibiotics and had been seen by a physician. The finding is consistent with the hypothesis of an infectious mechanism in SIDS induced by local microorganism growth and toxin or cytokine production, and also adds further support to a possible association between infection and SIDS by loss of protective mechanisms, such as arousal. The risk of SIDS among infants with the combined presence of infectious symptoms and either of the other modifiable risk factors, prone sleeping, head covered or parental smoking, was far greater than the sum of each individual factor. These risk factors thus modify the dangerousness of infection in infancy.
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Skjaerven R, Wilcox AJ, Lie RT. A population-based study of survival and childbearing among female subjects with birth defects and the risk of recurrence in their children. N Engl J Med 1999; 340:1057-62. [PMID: 10194234 DOI: 10.1056/nejm199904083401401] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND METHODS Persons with birth defects are at high risk for death during the perinatal period and infancy. Less is known about the later survival or reproduction of such persons. We studied a cohort that comprised 8192 women and adolescent girls with registered birth defects and 451,241 women and adolescent girls with no birth defects, all of whom were born in Norway from 1967 through 1982. The rate of survival was determined through 1992, and the rate of childbearing was determined through October 1997. We also estimated the risk of birth defects in the children of these subjects. RESULTS Among the subjects with birth defects, 80 percent survived to 15 years of age, as compared with 98 percent of those with no birth defects. Among the surviving subjects, 53 percent of those with birth defects gave birth to at least one infant by the age of 30 years, as compared with 67 percent of those with no birth defects. The subjects with birth defects were one third less likely to give birth by the age of 30 than those with no birth defects. The children of the subjects with birth defects had a significantly higher risk of birth defects than the children of those with no birth defects (relative risk, 1.6; 95 percent confidence interval, 1.3 to 2.1). This increased risk was confined entirely to the specific defect carried by the mother, with the relative risk of recurrence varying from 5.5 to 82 according to the defect. In contrast, there was no increase in the risk of having an infant with a different type of defect. CONCLUSIONS Women and girls with birth defects have decreased survival as compared with those with no birth defects, especially in the first years of life, and are less likely to have children. In addition, they have an increased risk of having children with the same defect.
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Affiliation(s)
- R Skjaerven
- Section for Medical Statistics and the Medical Birth Registry of Norway, University of Bergen.
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50
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Abstract
OBJECTIVES This study explored the extent of errors in gestational age as ascertained by last menstrual period. METHODS More than 1.5 million birth records (covering the years 1967-1994) from the population-based Medical Birth Registry of Norway were used to study variation in gestational age within strata of birthweight. RESULTS Within 100-g strata of birthweight, it was found that the observed gestational age distribution could be divided into 3 distinct underlying distributions separated by approximately 4 weeks. This pattern was present through all birthweight strata, from 200 g up to 4700 g. In addition, the apparent misclassification causing a gestational age 4 weeks too short was much more common among low-birthweight births than among heavier births. CONCLUSIONS The separation of the gestational age distributions by intervals of close to 4 weeks suggests that errors in gestational age measurements are caused by factors related to menstrual bleeding. Furthermore, there is evidence for a strong relation between bleeding at the time of the next menstrual period after conception and low birthweight. This conclusion should be approached with caution because of the retrospective nature of the data.
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Affiliation(s)
- H K Gjessing
- Division for Medical Statistics, University of Bergen, Norway.
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