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Bergman, Eva
Publications (9 of 9) Show all publications
Lindström, L., Ahlsson, F., Lundgren, M., Bergman, E., Lampa, E. & Wikström, A.-K. (2019). Growth patterns during early childhood in children born small for gestational age and moderate preterm. Scientific Reports, 9, Article ID 11578.
Open this publication in new window or tab >>Growth patterns during early childhood in children born small for gestational age and moderate preterm
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2019 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, article id 11578Article in journal (Refereed) Published
Abstract [en]

Today we lack knowledge if size at birth and gestational age interacts regarding postnatal growth pattern in children born at 32 gestational weeks or later.

This population-based cohort study comprised 41,669 children born in gestational weeks 32-40 in Uppsala County, Sweden, between 2000 and 2015. We applied a generalized least squares model including anthropometric measurements at 1.5, 3, 4 and 5 years. We calculated estimated mean height, weight and BMI for children born in week 32+0, 35+0 or 40+0 with birthweight 50th percentile (standardized appropriate for gestational age, sAGA) or 3rd percentile (standardized small for gestational age, sSGA).

Compared with children born sAGA at gestational week 40+0, those born sAGA week 32+0 or 35+0 had comparable estimated mean height, weight and BMI after 3 years of age. Making the same comparison, those born sSGA week 32+0 or 35+0 were shorter and lighter with lower estimated mean BMI throughout the whole follow-up period.

Our findings suggest that being born SGA and moderate preterm is associated with short stature and low BMI during the first five years of life. The association seemed stronger the shorter gestational age at birth.

Keywords
Postnatal growth, preterm birth, SGA, pregnancy, epidemiology
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology; Pediatrics; Epidemiology
Identifiers
urn:nbn:se:uu:diva-392437 (URN)10.1038/s41598-019-48055-x (DOI)
Funder
Swedish Research Council, 2014-3561
Available from: 2019-09-04 Created: 2019-09-04 Last updated: 2019-09-13Bibliographically approved
Lindström, L., Wikström, A.-K., Bergman, E., Mulic-Lutvica, A., Högberg, U., Ahlsson, F. & Lundgren, M. (2019). Postnatal growth in children born small for gestational age with and without smoking mother. Pediatric Research, 85(7), 961-966
Open this publication in new window or tab >>Postnatal growth in children born small for gestational age with and without smoking mother
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2019 (English)In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 85, no 7, p. 961-966Article in journal (Refereed) Published
Abstract [en]

Background: Maternal smoking impairs fetal growth; however, if postnatal growth differs between children born small for gestational age (SGA) with smoking and non-smoking mother is unknown.

Methods: Cohort-study of term born children born appropriate for gestational age with non-smoking mother (AGA-NS, n=30,561), SGA (birthweight <10th percentile) with smoking mother (SGA-S, n=171) or SGA with non-smoking mother (SGA-NS, n=1761). Means of height and weight measurements, collected at birth, 1.5, 3, 4 and 5 years, were compared using a generalized linear mixed effect model. Relative risks of short stature (<10th percentile) were expressed as adjusted risk ratios (aRR).

Results: At birth, children born SGA-S were shorter than SGA-NS, but they did not differ in weight. At 1.5 years, SGA-S had reached the same height as SGA-NS. At 5 years, SGA-S were 1.1 cm taller and 1.2 kg heavier than SGA-NS. Compared with AGA-NS, SGA-S did not have increased risk of short stature at 1.5 or 5 years, while SGA-NS had increased risk of short stature at both ages; aRRs 3.0 (95% CI 2.6;3.4) and 2.3 (95% CI 2.0;2.7), respectively.

Conclusions: Children born SGA-S have a more rapid catch-up growth than SGA-NS. This may have consequences for metabolic and cardiovascular health in children with smoking mothers.

National Category
Obstetrics, Gynecology and Reproductive Medicine Pediatrics
Identifiers
urn:nbn:se:uu:diva-374779 (URN)10.1038/s41390-019-0352-5 (DOI)000468524800013 ()30808020 (PubMedID)
Funder
Swedish Research Council, 2014-3561
Available from: 2019-01-24 Created: 2019-01-24 Last updated: 2019-09-05Bibliographically approved
Lindström, L., Wikström, A.-K., Bergman, E. & Lundgren, M. (2017). Born Small for Gestational Age and Poor School Performance: How Small Is Too Small?. Hormone Research in Paediatrics, 88, 215-223
Open this publication in new window or tab >>Born Small for Gestational Age and Poor School Performance: How Small Is Too Small?
2017 (English)In: Hormone Research in Paediatrics, ISSN 1663-2818, E-ISSN 1663-2826, Vol. 88, p. 215-223Article in journal (Refereed) Published
Abstract [en]

Aim: To assess the relationship between severity of small for gestational age (SGA) and risk of poor school performance, and to investigate whether adult stature modifies this risk.

Methods: 1,088,980 term Swedish children born 1973-1988 were categorized into severe SGA (<-3 standard deviations (SD) of expected birth weight), moderate SGA (-2.01 to -3 SD), mild SGA (-1.01 to -2 SD) and appropriate for gestational age (-1 to 0.99 SD). Risk of poor school performance at time of graduating from compulsory school (grades <10th percentile) was calculated using unconditional logistic regression models and adjusted for socioeconomic factors. In a sub-analysis, we stratified boys by adult stature, and adjusted for maternal but not paternal height.

Results: All SGA groups were significantly associated with increased risk of poor school performance, with adjusted odds ratios (aOR) and 95% confidence intervals (CI) ranging from 1.85 (1.65-2.07) for severe SGA to 1.25 (1.22-1.28) for mild SGA. In the sub-analysis, all birth weight groups were associated with increased risk of poor school performance among boys with short staturecompared with non-short stature.

Conclusion: Mild SGA is associated with significantly increased risk of poor school performance, and the risk increases with severity of SGA. Further, this risk diminishes after adequate catch-up growth.

Keywords
Small for gestational age, intrauterine growth, cognitive development, catch-up growth, stature
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-330118 (URN)10.1159/000477905 (DOI)000415251200005 ()28697501 (PubMedID)
Projects
Perspectives on Intrauterine Growth and Perinatal Exposure
Funder
Swedish Research Council, 2014-3561
Available from: 2017-09-26 Created: 2017-09-26 Last updated: 2019-02-20Bibliographically approved
Lindström, L., Skjaerven, R., Bergman, E., Lundgren, M., Klungsøyr, K., Cnattingius, S. & Wikström, A.-K. (2017). Chronic hypertension in women after perinatal exposure to preeclampsia, being born small for gestational age or preterm. Paediatric and Perinatal Epidemiology, 31(2), 89-98
Open this publication in new window or tab >>Chronic hypertension in women after perinatal exposure to preeclampsia, being born small for gestational age or preterm
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2017 (English)In: Paediatric and Perinatal Epidemiology, ISSN 0269-5022, E-ISSN 1365-3016, Vol. 31, no 2, p. 89-98Article in journal (Refereed) Published
Abstract [en]

Background: There is an established association between adverse events during perinatal life and chronic hypertension in adult life. However, disadvantageous conditions often coexist in the same pregnancy. We investigated single and joint perinatal exposure to preeclampsia, being born small for gestational age (SGA) or preterm and subsequent risk of chronic hypertension.

 

Methods: The study population consisted of 731,008 primiparous women from Norway and Sweden registered in the Medical Birth Registers, both as infants and as first time mothers between 1967-2009 (Norway) and 1973-2010 (Sweden). Risk of chronic hypertension in early pregnancy was calculated in women perinatally exposed to preeclampsia, born SGA or preterm by log-binominal regression analysis, and adjusted for maternal age and level of education in the 1st generation.

 

Results: The rate of chronic hypertension was 0.4%. Risk of chronic hypertension was associated with single perinatal exposure to preeclampsia, being born SGA or preterm with adjusted relative risks (95% confidence intervals, CI) 2.2 (95% CI 1.8, 2.7), 1.1 (95% CI 1.0, 1.3) and 1.3 (95% CI 1.0, 1.5) respectively. The risks increased after joint exposures, with an almost 4-fold risk increase after perinatal exposure to preeclampsia and preterm birth. Additional adjustment for BMI and smoking in the 2nd generation in a subset of the cohort only had a minor impact on the results.

 

Conclusions: Perinatal exposure to preeclampsia, being born SGA or preterm is independently associated with increased risk of chronic hypertension. The highest risk was seen after exposure to preeclampsia, especially if combined with SGA or preterm birth.

Keywords
chronic hypertension, preeclampsia, preterm birth, small for gestational age
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:uu:diva-319182 (URN)10.1111/ppe.12346 (DOI)000395008000001 ()28218407 (PubMedID)
Funder
Swedish Research Council, 2014-3561The Karolinska Institutet's Research Foundation
Available from: 2017-03-31 Created: 2017-03-31 Last updated: 2019-02-20Bibliographically approved
Bergman, E., Axelsson, O., Kieler, H., Sonesson, C. & Petzold, M. (2011). Relative growth estimated from self-administered symphysis fundal measurements. Acta Obstetricia et Gynecologica Scandinavica, 90(2), 179-185
Open this publication in new window or tab >>Relative growth estimated from self-administered symphysis fundal measurements
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2011 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 90, no 2, p. 179-185Article in journal (Refereed) Published
Abstract [en]

Objective. To establish absolute-and relative-growth reference curves for the detection of intrauterine growth restriction from weekly self-administered symphysis-fundus (SF) measurements and to assess the influence of fetal sex, maternal obesity and parity. Design. Prospective longitudinal study. Setting. Pregnant women from six primary antenatal care centres. Population. Three hundred women with singleton ultrasound dated pregnancies. Methods. Weekly self-administered SF measurements from gestational week 25 until delivery were obtained. A linear mixed longitudinal model was used to estimate the absolute SF growth using the natural logarithm (lnSF). Relative lnSF growth was calculated as the lnSF measurement in one gestational week subtracted by the lnSF measurement in the previous gestational week. The influence of fetal sex, maternal obesity and parity was assessed in regression models and by a graphical display. Main Outcome Measures. Absolute lnSF and relative lnSF growth curves and influence of fetal sex, maternal obesity and parity on these. Results. SF measurements from 191 women were used to establish an SF-growth reference. The absolute lnSF growth was influenced by maternal obesity, and for fetal sex and parity, borderline significance was recorded; while there was no evidence that the relative lnSF growth could depend on these variables. Conclusions. Weekly self-administered SF measurements can be obtained and used to estimate SF growth. Relative growth of the lnSF height seems to be independent of fetal sex, maternal obesity and parity.

Keywords
symphysis-fundus measurements, self-administered, intrauterine growth retardation (IUGR), small for gestational age (SGA), relative growth
National Category
Medical and Health Sciences
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:uu:diva-122243 (URN)10.1111/j.1600-0412.2010.01026.x (DOI)000287068700009 ()21241264 (PubMedID)
Projects
Symphysis Fundus Measurements for Detection of Intrauterine Growth Retardation
Available from: 2010-04-09 Created: 2010-04-07 Last updated: 2017-12-12Bibliographically approved
Bergman, E., Axelsson, O., Petzold, M., Sonesson, C. & Kieler, H. (2011). Self-administered symphysis-fundus measurements analyzed with a novel statistical method for detection of intrauterine growth restriction: a clinical evaluation. Acta Obstetricia et Gynecologica Scandinavica, 90(8), 890-896
Open this publication in new window or tab >>Self-administered symphysis-fundus measurements analyzed with a novel statistical method for detection of intrauterine growth restriction: a clinical evaluation
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2011 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 90, no 8, p. 890-896Article in journal (Refereed) Published
Abstract [en]

Objective. To assess the ability of self-administered symphysis fundus measurements used with the Shiryaev-Roberts statistical method (SR method) to identify growth-restricted (IUGR) fetuses and compare it with the traditional SF method (symphysis fundus measurements used with a population-based reference curve). Design. Longitudinal study. Setting. Pregnant women attending primary antenatal care centres. Population. From a population of 1 888 women with singleton ultrasound-dated pregnancies, we analyzed data from 1 122 women. Methods. Weekly self-administered SF measurements from gestational week 25 until delivery were analyzed according to the SR method. Neonatal morbidity and small for gestational age (SGA) were used as proxies for IUGR. Small for gestational age was defined as a birthweight less than two standard deviations (SD) and <10th percentile. We assessed the sensitivity of the SR and the SF methods to detect neonatal morbidity and SGA. Main Outcome Measures. Birth-related mortality, respiratory distress, hypoglycemia, Apgar score <= 6 at five minutes, pH <= 7.00 in the umbilical artery, neonatal care, preterm delivery, operative delivery for fetal distress and SGA. Results. For the SR method, the sensitivity for neonatal morbidity was between 6.0 and 36.4%, for SGA <2SD 36.8%, and for SGA <10th percentile 20.9%. The SF method had a sensitivity between 6.0 and 13.8% for neonatal morbidity, 52.3% for SGA <2SD and 28.6% for SGA <10th percentile. Conclusions. The SR and the SF methods had low sensitivities for neonatal morbidity.

Keywords
Fetal monitoring, symphysis-fundus measurement, self-administration, intrauterine growth restriction, small for gestational age, relative growth, fetal growth
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-157016 (URN)10.1111/j.1600-0412.2011.01181.x (DOI)000293151900013 ()
Available from: 2011-08-16 Created: 2011-08-15 Last updated: 2017-12-08Bibliographically approved
Bergman, E., Kieler, H., Petzold, M., Sonesson, C. & Axelsson, O. (2007). Self-administered measurement of symphysis-fundus heights. Acta Obstetricia et Gynecologica Scandinavica, 86(6), 671-677
Open this publication in new window or tab >>Self-administered measurement of symphysis-fundus heights
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2007 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 86, no 6, p. 671-677Article in journal (Refereed) Published
Abstract [en]

Background. Antenatal identification of infants small for gestational age (SGA) improves their perinatal outcome. Repeated measurements of the symphysis-fundus (SF) heights performed by midwives is the most widespread screening method for detection of SGA. However the insufficiency of this method necessitates improved practices. Earlier start and more frequent SF measurements, which could be acomplished by self-administered measurements, might improve the ability to detect deviant growth. The present study was set up to evaluate wether pregnant wome can reliable perform SF measurements by themself. Method. Forty healthy women with singelton and ultrasound-dated pregancies from 2 antenatal clinics in Uppsala, Sweden, were asked to perform 4 consecutive SF measureemnts once a week, from 20 to 25 weeks of gestation until delivery. The self-administered SF measurements were recorded and systematically compared with midwives' SF measurements. Results. Thirty-three pregnant women performed self-administered SF measurements over a 14-week period (range 1-21). The SF curves constructed from self-admiinistered SF measurements had the same shape as previously constructed population-based reference curves. The variance for self-admiinistered SF measurements was higher than that of the midwives. Conclusions. Pregnant women are capable of measuring SF heights by themselves, but with a higher individual variance than midwives. Repeated measurements at each occasion can compensate for the higher variance. The main advantage of self-administered SF measurements is the opportunity to follow fetal growth earlier and more frequently.

Keywords
Symphysis-fundus measurements, self-administered, intrauterine growth retardation, small for gestational age
National Category
Medical and Health Sciences
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:uu:diva-11151 (URN)10.1080/00016340701258867 (DOI)000248084100007 ()17520397 (PubMedID)
Projects
Symphysis Fundus Measurements for Detection of Intrauterine Growth Restriction
Available from: 2007-06-04 Created: 2007-06-04 Last updated: 2017-12-11Bibliographically approved
Bergman, E., Kieler, H., Petzold, M. G., Sonesson, C. & Axelsson, O. (2006). Symphysis-fundus measurements for detection of small for gestational age pregnancies. Acta Obstetricia et Gynecologica Scandinavica, 85(4), 407-12
Open this publication in new window or tab >>Symphysis-fundus measurements for detection of small for gestational age pregnancies
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2006 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 85, no 4, p. 407-12Article in journal (Refereed) Published
Abstract [en]

Background. In Sweden measurements of the symphysis-fundus (SF) distance are used to detect small for gestational age (SGA) pregnancies. The aim of this study was to evaluate the efficiency of Swedish ultrasound-based SF reference curves in detecting SGA pregnancies. Methods. To assess the sensitivity for detection of SGA pregnancies we performed a case-control study. Through the Swedish Medical Birth Register we identified all singelton SGA infants born in Uppsala 1993-1997 and randomly recruited non-SGA singelton as controls. We included 169 term and 73 preterm SGA cases and 296 controls, all born at term. The reference curves constructed from Steingrimsdottir (S curve) and Kieler (K curve) were evaluated. Gestational age at first alarm in the preterm SGA group was recorded. Results. In term pregnancies the S curve showed a sensitivity of 32 % and a specificity of 90 % at a cut-off at -2 SDs. The corresponding values for the K curve were 51 % and 83 %, respectively. In preterm pregnancies the sensitivity of the S curve was 49 % and for the K curve 58 %. The first alarm below -2 SD was noted before 32 weeks in 37 % with the S curve and 43 % with the K curve for preterm pregnancies. Conclusions. Both tested Swedish reference curves had low sensitivity for term SGA pregnancies. Sensitivity was higher for the preterm group and SF measurements seem to be better for detecting the most severe cases of SGA.

National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:uu:diva-81985 (URN)16612701 (PubMedID)
Projects
Symphysis Fundus Measurements for Detection of Intrauterine Growth Restriction
Available from: 2010-03-31 Created: 2006-10-17 Last updated: 2017-12-14Bibliographically approved
Petzold, M., Sonesson, C., Bergman, E. & Kieler, H. (2004). Surveillance in longitudinal models: Detection of intrauterine growth restriction. Biometrics (60), 1025-1033
Open this publication in new window or tab >>Surveillance in longitudinal models: Detection of intrauterine growth restriction
2004 (English)In: Biometrics, no 60, p. 1025-1033Article in journal (Refereed) Published
Keywords
Growth; IUGR; Monitoring; Shiryaev-Roberts method; Surveillance; Symphysis-fundus
Identifiers
urn:nbn:se:uu:diva-67573 (URN)
Available from: 2004-12-13 Created: 2004-12-13 Last updated: 2011-01-12
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