Logo: to the web site of Uppsala University

uu.sePublications from Uppsala University
Change search
Link to record
Permanent link

Direct link
Alternative names
Publications (10 of 17) Show all publications
Starke, V., Diderholm, B., Heyman, M. & Thernström Blomqvist, Y. (2023). Being parents of extremely preterm children, from a long-term perspective: A qualitative study of parents' experiences. Early Human Development, 183, Article ID 105819.
Open this publication in new window or tab >>Being parents of extremely preterm children, from a long-term perspective: A qualitative study of parents' experiences
2023 (English)In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 183, article id 105819Article in journal (Refereed) Published
Abstract [en]

Background

In recent decades, modern neonatal intensive care has improved, increasing the survival of extremely preterm children. Few studies have examined the experiences of parents of extremely preterm children from a long-term perspective.

Aim

To describe parents' experiences of parenting extremely preterm children during their childhood and transition to adulthood.

Study design

A qualitative interview study with a descriptive design.

Subjects

Thirteen parents of eleven children born at 24 gestational weeks in Sweden, 1990–1992, participated in individual semi-structured interviews.

Outcome measures

Data were analyzed using qualitative reflexive thematic analysis.

Result

Five themes forming a timeline were created in the analytic process: parenthood, at the NICU, young childhood, adolescence, and adulthood. Various aspects affecting parenthood were described throughout the timeline, and occasionally the parents experienced difficulties dealing with their children's special physical and/or mental needs. Today, some families have established a functioning situation despite their children's physical and/or mental difficulties, while some still struggle with their children's everyday life.

Conclusion

Having an extremely preterm family member profoundly affects the whole family for various lengths of time. Parents expressed a need for support from both healthcare and school throughout their children's childhood and in their transition to adulthood, although the need varies between parent–child pairs. By studying the parents' experiences, their need for support can be further recognized and understood, and developed and improved accordingly.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Adults born extremely preterm, Extremely preterm children, Neonatal intensive care, Parents' experiences, Parents' perspectives, Qualitative research
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-507570 (URN)10.1016/j.earlhumdev.2023.105819 (DOI)001034532800001 ()37393662 (PubMedID)
Funder
Gillbergska stiftelsenSolstickan Foundation
Available from: 2023-07-08 Created: 2023-07-08 Last updated: 2023-08-18Bibliographically approved
Norrgrann, M., Hörnfeldt, M., Latheef, F., Thernström Blomqvist, Y., Larsson, A., Paulsson, M. & Diderholm, B. (2023). Lipid Peroxidation and Antioxidative Capacity Are Unaltered in Transitional Breast Milk Exposed to Light from Women Giving Birth to Preterm Infants before 32 Weeks of Gestation. Nutrients, 15(12), Article ID 2818.
Open this publication in new window or tab >>Lipid Peroxidation and Antioxidative Capacity Are Unaltered in Transitional Breast Milk Exposed to Light from Women Giving Birth to Preterm Infants before 32 Weeks of Gestation
Show others...
2023 (English)In: Nutrients, E-ISSN 2072-6643, Vol. 15, no 12, article id 2818Article in journal (Refereed) Published
Abstract [en]

Breast milk (BM) is the primary nutrition for infants and has a high content of lipids. Preterm infants receive expressed BM via tube feeding, and they are frequently treated with phototherapy. When parenteral nutrition (PN) is exposed to light and/or phototherapy, lipid peroxidation (LPO) increases. By light-protecting PN, morbidity and mortality are reduced in preterm infants through the reduction of oxidative stress. We aimed to investigate whether light-protecting breast milk could reduce LPO. Twelve mothers giving birth to a preterm infants of less than 32 weeks of gestational age were included. Transitional BM was collected and divided into three study groups; light-protected, ward light and phototherapy light. Baseline samples were collected after expression and the exposures started within one hour. Feeding syringe samples were exposed to light for 30 up to 360 min. Nasogastric tube samples were run through a tube under the same light conditions. Samples were stored in -80 °C until analyses of malondialdehyde (MDA), 4-hydroxynonenal (4-HNE) and total antioxidant capacity (TAC). There were no significant differences in MDA, 4-HNE or TAC levels observed between the different study groups. This study indicates that the light exposure of expressed transitional BM does not affect LPO and the levels of MDA, 4-HNE or TAC.

Place, publisher, year, edition, pages
MDPI, 2023
Keywords
4-hydroxynonenal, enteral nutrition, human breast milk, light protection, lipid peroxidation, malondialdehyde, naso-gastric tube feeding, phototherapy, preterm infants, total antioxidant capacity
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-507422 (URN)10.3390/nu15122818 (DOI)001014786100001 ()37375721 (PubMedID)
Available from: 2023-07-06 Created: 2023-07-06 Last updated: 2023-08-28Bibliographically approved
Biskop Lindgren, E., Thernström Blomqvist, Y., Diderholm, B. & Grandahl, M. (2023). To Feel Abandoned in an Insecure Situation: Parents' Experiences of Separation From Their Newborn Due to the Mother Being COVID-19 Positive. Advances in Neonatal Care, 23(4), 304-310
Open this publication in new window or tab >>To Feel Abandoned in an Insecure Situation: Parents' Experiences of Separation From Their Newborn Due to the Mother Being COVID-19 Positive
2023 (English)In: Advances in Neonatal Care, ISSN 1536-0903, E-ISSN 1536-0911, Vol. 23, no 4, p. 304-310Article in journal (Refereed) Published
Abstract [en]

Background: 

The COVID-19 pandemic resulted in changes in neonatal care, sometimes resulting in a separation between parents and their newborn. Knowledge about parents' experiences of this separation is limited.

Purpose: 

To explore parents' experiences of separation from their newborn due to COVID-19.

Methods: 

Interviews with parents (n = 11) separated from their newborn.

Results: 

The parents' experiences of being separated from their newborn were expressed under 3 themes: “To create a sense of safety in an insecure situation”; “Unexpected start to parenthood”; and “To be reunited.” Parents felt abandoned and alone, even if they had support from significant others. Although they considered the separation as undesired, wanting to be with their newborn infant, it was secondary to not wanting to infect the infant with COVID-19. Furthermore, lacking information about a potentially lethal virus adds to the uncertainty that comes with having a newborn. The separation affected the whole family, some for a long time afterward.

Implications for Practice and Research: 

If a new situation with potentially life-threatening effects, like the COVID-19 pandemic, occurs again, considering the experiences of these parents is paramount. Precautions should be taken to minimize the potential harm. If a separation between newborns and parents is inevitable, parents need preparation and transparent information prior to the separation and before the reunion. Well-thought-out policies must be in place to minimize the impact of a separation on both parties. Parents should be able to have a deputy parent present during an undesired but necessary separation from their newborn.

Place, publisher, year, edition, pages
Wolters Kluwer, 2023
Keywords
COVID-19, neonatal intensive care unit, parents, perinatal, separation
National Category
Pediatrics Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-509999 (URN)10.1097/ANC.0000000000001073 (DOI)001039213900006 ()36999904 (PubMedID)
Funder
Swedish Research Council, 19040/19046H.R.H. Crown Princess Lovisa's Association for Child CareGillbergska stiftelsen
Available from: 2023-08-28 Created: 2023-08-28 Last updated: 2024-06-11Bibliographically approved
Gialamas, S., Sjostrom, E. S., Diderholm, B., Domellof, M. & Ahlsson, F. (2022). Amino acid infusions in umbilical artery catheters enhance protein administration in infants born at extremely low gestational age. Acta Paediatrica, 111(3), 536-545
Open this publication in new window or tab >>Amino acid infusions in umbilical artery catheters enhance protein administration in infants born at extremely low gestational age
Show others...
2022 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 111, no 3, p. 536-545Article in journal (Refereed) Published
Abstract [en]

Aim It is challenging to provide extremely low gestational age neonates (ELGANs) with adequate protein supply. This study aimed to investigate whether amino acid (AA) infusion in the umbilical artery catheter (UAC) in ELGANs is safe and enhances protein supply and growth.

Method A before and after study including infants born <27 weeks, treated in Uppsala, Sweden, during 2004-2007, compared those receiving normal saline/10% dextrose in water with those receiving AA infusion in the UAC. Data were retrieved from the Extremely Preterm Infants in Sweden Study, hospital records and the Swedish Neonatal Quality Register. Group comparisons, univariate and multivariate analyses were conducted.

Results AA group (n = 41, females 39%) received on average approximately 0.3 g/kg/day more protein during the first postnatal week, compared to control group (n = 30, females 40%) (unstandardised coefficient (B) 0.26, p .001) but no difference was noted during 8-28 postnatal days. The type of infusion was not associated with growth variables. The incidence of neonatal morbidities and UAC-related thrombosis did not differ between the groups.

Conclusion AA infusions in the UACs in ELGANs is safe and enhances protein supply during the first postnatal week. However, this practice is not associated with growth during the first 28 postnatal days.

Place, publisher, year, edition, pages
John Wiley & SonsWiley, 2022
Keywords
amino acids, extremely low gestational age, growth, protein intake, umbilical artery catheter
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-484825 (URN)10.1111/apa.16196 (DOI)000726707200001 ()34822182 (PubMedID)
Available from: 2022-09-19 Created: 2022-09-19 Last updated: 2024-01-15Bibliographically approved
Naseh, N., Canto Moreira, N., Vaz, T. F., Gonzalez Tamez, K., Ferreira, H., Fredriksson Kaul, Y., . . . Hellström-Westas, L. (2022). Early Hyperglycemia in Very Preterm Infants Is Associated with Reduced White Matter Volume and Worse Cognitive and Motor Outcomes at 2.5 Years. Neonatology, 119(6), 745-752
Open this publication in new window or tab >>Early Hyperglycemia in Very Preterm Infants Is Associated with Reduced White Matter Volume and Worse Cognitive and Motor Outcomes at 2.5 Years
Show others...
2022 (English)In: Neonatology, ISSN 1661-7800, E-ISSN 1661-7819, Vol. 119, no 6, p. 745-752Article in journal (Refereed) Published
Abstract [en]

Introduction: Hyperglycemia in very preterm infants is associated with increased morbidity and mortality. We aimed to investigate potential associations between early hyperglycemia, neonatal cerebral magnetic resonance imaging (MRI), and neurodevelopment at 2.5 years.

Methods: The study population included 69 infants with gestational age (GA) 22.3-31.9 weeks (n = 29 with GA <28 weeks), born 2011-2014. Plasma glucose concentrations during the first week were checked according to clinical routines. Hyperglycemia was defined as glucose concentrations above 8.3 mmol/L (150 mg/dL) and above 10 mmol/L (180 mg/dL), respectively, categorized as the highest glucose days 0-2, number of days above 8.3 and 10 mmol/L, and prolonged (yes/no) 2 days or more above 8.3 and 10 mmol/L. The MRI analysis included morphological assessment, regional brain volumes, and assessment of apparent diffusion coefficient (ADC). Neurodevelopmental impairment (NDI) developed in 13 of 67 infants with available outcomes, of which 57 were assessed with the Bayley-III. Univariate and multiple linear and logistic regressions were performed with adjustments for GA, birth weight z-scores, and illness severity expressed as days on mechanical ventilation.

Results: Hyperglycemia above 8.3 mmol/L and 10 mmol/L was present in 47.8% and 31.9% of the infants. Hyperglycemia correlated independently with lower white matter volume, but not with other regional brain volumes, and was also associated with lower ADC values in white matter. Hyperglycemia also correlated with lower Bayley-III cognitive and motor scores in infants with GA <28 weeks, but there was no significant effect on NDI.

Conclusion: Early hyperglycemia is associated with white matter injury and poorer neurodevelopment in very preterm infants.

Place, publisher, year, edition, pages
S. Karger, 2022
Keywords
Brain injury, Impairment, Insulin, Magnetic resonance imaging, Neurodevelopment
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-496804 (URN)10.1159/000524923 (DOI)000854938500001 ()36108597 (PubMedID)
Funder
Uppsala University
Available from: 2023-02-28 Created: 2023-02-28 Last updated: 2023-02-28Bibliographically approved
Diderholm, B., Normann, E., Ahlsson, F., Sindelar, R. & Ågren, J. (2022). The Impact of Restricted versus Liberal Early Fluid Volumes on Plasma Sodium, Weight Change, and Short-Term Outcomes in Extremely Preterm Infants. Nutrients, 14(4), Article ID 795.
Open this publication in new window or tab >>The Impact of Restricted versus Liberal Early Fluid Volumes on Plasma Sodium, Weight Change, and Short-Term Outcomes in Extremely Preterm Infants
Show others...
2022 (English)In: Nutrients, E-ISSN 2072-6643, Vol. 14, no 4, article id 795Article in journal (Refereed) Published
Abstract [en]

The optimal fluid requirements for extremely preterm infants are not fully known. We examined retrospectively the fluid intakes during the first week of life in two cohorts of extremely preterm infants born at 22-26 weeks of gestation before (n = 63) and after a change from a restrictive to a more liberal (n = 112) fluid volume allowance to improve nutrient provision. The cohorts were similar in gestational age and birth weight, but antenatal steroid exposure was more frequent in the second era. Although fluid management resulted in a cumulative difference in the total fluid intake over the first week of 87 mL/kg (p < 0.001), this was not reflected in a mean weight loss (14 +/- 5% at a postnatal age of 4 days in both groups) or mean peak plasma sodium (142 +/- 5 and 143 +/- 5 mmol/L in the restrictive and liberal groups, respectively). The incidences of hypernatremia (>145 and >150 mmol/L), PDA ligation, bronchopulmonary dysplasia, and IVH were also similar. We conclude that in this cohort of extremely preterm infants a more liberal vs. a restricted fluid allowance during the first week had no clinically important influence on early changes in body weight, sodium homeostasis, or hospital morbidities.

Place, publisher, year, edition, pages
MDPI AG, 2022
Keywords
extremely preterm infant, fluid allowance, dehydration
National Category
Nutrition and Dietetics Pediatrics
Identifiers
urn:nbn:se:uu:diva-469556 (URN)10.3390/nu14040795 (DOI)000761414000001 ()35215444 (PubMedID)
Available from: 2022-03-14 Created: 2022-03-14 Last updated: 2023-08-28Bibliographically approved
Olsson, E., Diderholm, B. & Thernström Blomqvist, Y. (2021). "Paying it Forward" - Swedish Women's Experiences of Donating Human Milk. Journal of Human Lactation, 37(1), 87-94, Article ID 0890334420979245.
Open this publication in new window or tab >>"Paying it Forward" - Swedish Women's Experiences of Donating Human Milk
2021 (English)In: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 37, no 1, p. 87-94, article id 0890334420979245Article in journal (Refereed) Published
Abstract [en]

Background Human milk is recommended as the only nutritional source during the first 6 months of life. For preterm infants, the benefits of human milk are even more important and can alleviate the negative influences of preterm birth. Research aim To describe how Swedish human milk donors experienced the donation process. Method A prospective mixed methods mail survey was designed. It was sent to human milk donors (N = 72) at two Swedish hospitals. Quantitative data are presented with descriptive statistics and qualitative data were analyzed using qualitative content analysis. Results The infants were between newborn and 17 weeks of age when the participants started their human milk donations, and the duration of the donation period lasted 1-24 weeks. The overall theme identified was the participants' strong desire to help infants, often expressed as being involved in saving infants' lives. Many participants experienced difficulties getting the information needed to become human milk donors; for others, expressing milk required both time and energy that they could otherwise spend with their own newborn infants. Conclusion Donating human milk can be experienced as a demanding and strenuous task. Therefore, it is important that women who donate human milk receive the practical help from health care staff that they feel they need. Furthermore, information and knowledge about the possibility of donating human milk, and how important human milk is for preterm and/or sick infants, are important in order to increase the number of women willing to donate human milk.

Place, publisher, year, edition, pages
Sage PublicationsSAGE PUBLICATIONS INC, 2021
Keywords
breastfeeding, breast pumping, human milk expression, milk banking
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-440097 (URN)10.1177/0890334420979245 (DOI)000628927200001 ()33275499 (PubMedID)
Funder
Gillbergska stiftelsen
Available from: 2021-04-16 Created: 2021-04-16 Last updated: 2024-01-15Bibliographically approved
Latheef, F., Wahlgren, H., Engstrand Lilja, H., Diderholm, B. & Paulsson, M. (2021). The Risk of Necrotizing Enterocolitis following the Administration of Hyperosmolar Enteral Medications to Extremely Preterm Infants. Neonatology, 118(1), 73-79
Open this publication in new window or tab >>The Risk of Necrotizing Enterocolitis following the Administration of Hyperosmolar Enteral Medications to Extremely Preterm Infants
Show others...
2021 (English)In: Neonatology, ISSN 1661-7800, E-ISSN 1661-7819, Vol. 118, no 1, p. 73-79Article in journal (Refereed) Published
Abstract [en]

Introduction: Necrotizing enterocolitis (NEC) is a disease predominantly affecting preterm infants. The administration of hyperosmolar solutions could lead to the development of NEC. The objective of this study was to measure the osmolality of enteral medications used in clinical practice and to assess the risk of NEC following exposure to hyperosmolar medications.

Methods: A retrospective cohort study in extremely preterm infants (gestational age <28 weeks) born between 2010 and 2016 at a tertiary neonatal intensive care unit in Sweden. 465 infants were identified via the Swedish Neonatal Quality register. Data relating to enteral administrations received during a two-week period were collected from the medical records. The osmolalities of medications were measured using an osmometer. Logistic regression was used to calculate the odds ratio of developing NEC.

Results: A total of 253 patients met the inclusion criteria. The osmolalities of 5 commonly used medications significantly exceeded the recommended limit of 450 mOsm/kg set by the American Academy of Paediatrics (AAP). Most patients (94%) received at least one hyperosmolar medication. No significant risk of developing NEC could be found.

Conclusion: The medications used in clinical practice can significantly exceed the limit set by the AAP. This study does not indicate an increased risk of developing NEC in extremely preterm infants following exposure to hyperosmolar medications. Further studies in larger cohorts are needed to determine the specific cut-off level of osmolality in relation to the pathogenesis of NEC.

Place, publisher, year, edition, pages
S. KargerS. Karger AG, 2021
Keywords
Osmolality, Extremely preterm infant, Oral medication, Necrotizing enterocolitis, Safety
National Category
Pediatrics Nursing
Identifiers
urn:nbn:se:uu:diva-447457 (URN)10.1159/000513169 (DOI)000617009900001 ()33567438 (PubMedID)
Funder
Gillbergska stiftelsen
Available from: 2021-07-01 Created: 2021-07-01 Last updated: 2024-01-15Bibliographically approved
Nyholm, S., Edner, A., Myrelid, Å., Janols, H., Dörenberg, R. & Diderholm, B. (2020). Invasive mechanical ventilation in a former preterm infant with COVID-19. Acta Paediatrica, 109(10), 2141-2143
Open this publication in new window or tab >>Invasive mechanical ventilation in a former preterm infant with COVID-19
Show others...
2020 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 109, no 10, p. 2141-2143Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
WILEY, 2020
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-439669 (URN)10.1111/apa.15437 (DOI)000545349500001 ()32569422 (PubMedID)
Available from: 2021-04-09 Created: 2021-04-09 Last updated: 2021-04-09Bibliographically approved
Gyllenhammar, I., Diderholm, B., Gustafsson, J., Berger, U., Ridefelt, P., Benskin, J. P., . . . Glynn, A. (2018). Perfluoroalkyl acid levels in first-time mothers in relation to offspring weight gain and growth. Environment International, 111, 191-199
Open this publication in new window or tab >>Perfluoroalkyl acid levels in first-time mothers in relation to offspring weight gain and growth
Show others...
2018 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 111, p. 191-199Article in journal (Refereed) Published
Abstract [en]

We investigated if maternal body burdens of perfluoroalkyl acids (PFAAs) at the time of delivery are associated with birth outcome and if early life exposure (in utero/nursing) is associated with early childhood growth and weight gain. Maternal PFAA body burdens were estimated by analysis of serum samples from mothers living in Uppsala County, Sweden (POPUP), sampled three weeks after delivery between 1996 and 2011. Data on child length and weight were collected from medical records and converted into standard deviation scores (SDS). Multiple linear regression models with appropriate covariates were used to analyze associations between maternal PFAA levels and birth outcomes (n=381). After birth Generalized Least Squares models were used to analyze associations between maternal PFAA and child growth (n=200). Inverse associations were found between maternal levels of perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluoroundecanoic acid (PFUnDA), and birth weight SDS with a change of -0.10 to -0.18 weight SDS for an inter-quartile range (IQR) increase in ng/g PFAA. After birth, weight and length SDS were not significantly associated with maternal PFAA. However, BMI SDS was significantly associated with PFOA, PFNA, and PFHxS at 3 and 4years of age, and with PFOS at 4 and 5years of age. If causal, these associations suggest that PFAA affects fetal and childhood body development in different directions.

National Category
Clinical Medicine
Identifiers
urn:nbn:se:uu:diva-343486 (URN)10.1016/j.envint.2017.12.002 (DOI)000423441500020 ()29223808 (PubMedID)
Funder
Swedish Environmental Protection Agency, 219 1202Swedish Research Council Formas, 2010-1300Swedish Civil Contingencies Agency, dnr 1637/2012
Available from: 2018-02-27 Created: 2018-02-27 Last updated: 2018-03-07Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-2953-5485

Search in DiVA

Show all publications