uu.seUppsala University Publications
Change search
Link to record
Permanent link

Direct link
BETA
Publications (10 of 37) Show all publications
Fadl, H., Saeedi, M., Montgomery, S., Magnuson, A., Schwarcz, E., Berntorp, K., . . . Simmons, D. (2019). Changing diagnostic criteria for gestational diabetes in Sweden-a stepped wedge national cluster randomised controlled trial-the CDC4G study protocol. BMC Pregnancy and Childbirth, 19(1), Article ID 398.
Open this publication in new window or tab >>Changing diagnostic criteria for gestational diabetes in Sweden-a stepped wedge national cluster randomised controlled trial-the CDC4G study protocol
Show others...
2019 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 19, no 1, article id 398Article in journal (Refereed) Published
Abstract [en]

Background: The optimal criteria to diagnose gestational diabetes mellitus (GDM) remain contested. The Swedish National Board of Health introduced the 2013 WHO criteria in 2015 as a recommendation for initiation of treatment for hyperglycaemia during pregnancy. With variation in GDM screening and diagnostic practice across the country, it was agreed that the shift to new guidelines should be in a scientific and structured way. The aim of the Changing Diagnostic Criteria for Gestational Diabetes (CDC4G) in Sweden (www.cdc4g.se/en) is to evaluate the clinical and health economic impacts of changing diagnostic criteria for GDM in Sweden and to create a prospective cohort to compare the many long-term outcomes in mother and baby under the old and new diagnostic approaches.

Methods: This is a stepped wedge cluster randomised controlled trial, comparing pregnancy outcomes before and after the switch in GDM criteria across 11 centres in a randomised manner. The trial includes all pregnant women screened for GDM across the participating centres during January–December 2018, approximately two thirds of all pregnancies in Sweden in a year. Women with pre-existing diabetes will be excluded. Data will be collected through the national Swedish Pregnancy register and for follow up studies other health registers will be included.

Discussion: The stepped wedge RCT was chosen to be the best study design for evaluating the shift from old to new diagnostic criteria of GDM in Sweden. The national quality registers provide data on the whole pregnant population and gives a possibility for follow up studies of both mother and child. The health economic analysis from the study will give a solid evidence base for future changes in order to improve immediate pregnancy, as well as long term, outcomes for mother and child.

Trial registration: CDC4G is listed on the ISRCTN registry with study ID ISRCTN41918550 (15/12/2017)

Place, publisher, year, edition, pages
BMC, 2019
Keywords
Gestational diabetes mellitus, Pregnancy outcomes, Diagnostic criteria, WHO 2013 criteria, Stepped wedge cluster randomised controlled trial, LGA, Health economics, Obesity
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-397640 (URN)10.1186/s12884-019-2547-5 (DOI)000494447700004 ()31675922 (PubMedID)
Funder
Swedish Research Council, 2018-00470
Available from: 2019-11-22 Created: 2019-11-22 Last updated: 2019-11-22Bibliographically approved
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
Show others...
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)000480233800030 ()31399623 (PubMedID)
Funder
Swedish Research Council, 2014-3561
Available from: 2019-09-04 Created: 2019-09-04 Last updated: 2019-12-09Bibliographically approved
Wahlström Johnsson, I., Ahlsson, F. & Gustafsson, J. (2019). High birthweight was not associated with altered body composition or impaired glucose tolerance in adulthood. Acta Paediatrica, 108(12), 2208-2213
Open this publication in new window or tab >>High birthweight was not associated with altered body composition or impaired glucose tolerance in adulthood
2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 12, p. 2208-2213Article in journal (Refereed) Published
Abstract [en]

Aim

To investigate whether a high birthweight was associated with an increased proportion of body fat or with impaired glucose tolerance in adulthood.

Methods

Our cohort comprised 27 subjects with birthweights of 4500 g or more, and 27 controls with birthweights within ±1 standard deviation scores, born at Uppsala University Hospital 1975‐1979. The subjects were 34‐40 years old at the time of study. Anthropometric data was collected, and data on body composition was obtained by air plethysmography and bioimpedance and was estimated with a three‐compartment model. Indirect calorimetry, blood sampling for fasting insulin and glucose as well as a 75 g oral glucose tolerance test were also performed. Insulin sensitivity was assessed using homoeostasis model assessment 2 and Matsuda index.

Results

There were no differences in body mass index, body composition or insulin sensitivity between subjects with a high birthweight and controls.

Conclusion

In this cohort of adult subjects, although limited in size, those born with a moderately high birthweight did not differ from those with birthweights within ±1 standard deviation scores, regarding body composition or glucose tolerance.

Keywords
body composition, glucose tolerance, high birthweight, insulin sensitivity, obesity
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-398820 (URN)10.1111/apa.14928 (DOI)000479894000001 ()31295357 (PubMedID)
Funder
Novo Nordisk
Available from: 2019-12-13 Created: 2019-12-13 Last updated: 2019-12-13Bibliographically approved
Maessen, S. E., Ahlsson, F., Lundgren, M., Cutfield, W. S. & Derraik, J. G. B. (2019). Maternal smoking early in pregnancy is associated with increased risk of short stature and obesity in adult daughters. Scientific Reports, 9, Article ID 4290.
Open this publication in new window or tab >>Maternal smoking early in pregnancy is associated with increased risk of short stature and obesity in adult daughters
Show others...
2019 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, article id 4290Article in journal (Refereed) Published
Abstract [en]

We assessed anthropometry in 22,421 adult daughters in association with their mothers' tobacco smoking early in pregnancy (at their first antenatal visit) in Sweden, particularly their risk of short stature and obesity. Adult daughters were grouped by maternal smoking levels during pregnancy: Nonsmokers (58.5%), Light smokers (24.1%; smoked 1-9 cigarettes/day), and Heavier smokers (17.4%; smoked >= 10 cigarettes/day). Anthropometry was recorded on the adult daughters at approximately 26.0 years of age. Obesity was defined as BMI >= 30 kg/m(2), and short stature as height more than two standard deviations below the population mean. Daughters whose mothers were Light and Heavier smokers in early pregnancy were 0.8 cm and 1.0cm shorter, 2.3 kg and 2.6 kg heavier, and had BMI 0.84 kg/m(2) and 1.15 kg/m(2) greater, respectively, than daughters of Non-smokers. The adjusted relative risk of short stature was 55% higher in women born to smokers, irrespectively of smoking levels. Maternal smoking had a dose-dependent association with obesity risk, with offspring of Heavier smokers 61% and of Light smokers 37% more likely to be obese than the daughters of Non-smokers. In conclusion, maternal smoking in pregnancy was associated with an increased risk of short stature and obesity in their adult daughters.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-380451 (URN)10.1038/s41598-019-39006-7 (DOI)000460924100030 ()30862963 (PubMedID)
Available from: 2019-03-28 Created: 2019-03-28 Last updated: 2019-03-28Bibliographically approved
Grundvig Nylund, A., Gonzalez Lindh, M., Ahlsson, F. & Thernström Blomqvist, Y. (2019). Parents experiences of feeding their extremely preterm children during the first 2‐3 years – A qualitative study. ACTA PAEDIATRICA
Open this publication in new window or tab >>Parents experiences of feeding their extremely preterm children during the first 2‐3 years – A qualitative study
2019 (English)In: ACTA PAEDIATRICAArticle in journal (Refereed) Published
National Category
Medical and Health Sciences
Research subject
Pediatrics
Identifiers
urn:nbn:se:uu:diva-400399 (URN)onlinelibrary.wiley.com/doi/full/10.1111/apa.15060 (DOI)
Available from: 2019-12-20 Created: 2019-12-20 Last updated: 2020-02-06Bibliographically approved
Derraik, J. G. B., Pasupathy, D., McCowan, L. M., Poston, L., Taylor, R. S., Simpson, N. A., . . . Ahlsson, F. (2019). Paternal contributions to large-for-gestational-age term babies: findings from a multicenter prospective cohort study. Journal of Developmental Origins of Health and Disease, 10(5), 529-535, Article ID PII S2040174419000035.
Open this publication in new window or tab >>Paternal contributions to large-for-gestational-age term babies: findings from a multicenter prospective cohort study
Show others...
2019 (English)In: Journal of Developmental Origins of Health and Disease, ISSN 2040-1744, E-ISSN 2040-1752, Vol. 10, no 5, p. 529-535, article id PII S2040174419000035Article in journal (Refereed) Published
Abstract [en]

We assessed whether paternal demographic, anthropometric and clinical factors influence the risk of an infant being born large-for-gestational-age (LGA). We examined the data on 3659 fathers of term offspring (including 662 LGA infants) born to primiparous women from Screening for Pregnancy Endpoints (SCOPE). LGA was defined as birth weight >90th centile as per INTERGROWTH 21st standards, with reference group being infants <= 90th centile. Associations between paternal factors and likelihood of an LGA infant were examined using univariable and multivariable models. Men who fathered LGA babies were 180 g heavier at birth (P<0.001) and were more likely to have been born macrosomic (P<0.001) than those whose infants were not LGA. Fathers of LGA infants were 2.1 cm taller (P<0.001), 2.8 kg heavier (P<0.001) and had similar body mass index (BMI). In multivariable models, increasing paternal birth weight and height were independently associated with greater odds of having an LGA infant, irrespective of maternal factors. One unit increase in paternal BMI was associated with 2.9% greater odds of having an LGA boy but not girl; however, this association disappeared after adjustment for maternal BMI. There were no associations between paternal demographic factors or clinical history and infant LGA. In conclusion, fathers who were heavier at birth and were taller were more likely to have an LGA infant, but maternal BMI had a dominant influence on LGA.

Keywords
birth weight, BMI, body mass index, father, LGA, mother
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-395790 (URN)10.1017/S2040174419000035 (DOI)000487034700004 ()30813979 (PubMedID)
Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-10-25Bibliographically 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
Show others...
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
Skudder-Hill, L., Ahlsson, F., Lundgren, M., Cutfield, W. S. & Derraik, J. G. B. (2019). Preterm Birth is Associated With Increased Blood Pressure in Young Adult Women. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 8(12), Article ID e012274.
Open this publication in new window or tab >>Preterm Birth is Associated With Increased Blood Pressure in Young Adult Women
Show others...
2019 (English)In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 8, no 12, article id e012274Article in journal (Refereed) Published
Abstract [en]

Background-While there is some evidence of elevated blood pressure later in life in preterm survivors, data on adult women are still lacking. Thus, we assessed the associations between preterm birth and blood pressure in young adult women. Methods and Results-We studied 5232 young adult women who volunteered for military service in Sweden between 1990 and 2007. Anthropometric and clinic blood pressure data were collected during the medical examination at the time of conscription. There was a progressive decline in systolic and diastolic blood pressures, as well as in mean arterial pressure, with increasing gestational age. Women born preterm had an adjusted increase in systolic blood pressure of 3.8 mm Hg (95% CI, 2.5-5.1; P<0.0001) and mean arterial pressure of 1.9 mm Hg (95% CI, 0.9-2.8; P 0.0001) compared with young women born at term. Rates of systolic hypertension were also considerably higher in young women born preterm (14.0% versus 8.1%, P<0.0001), as were rates of isolated systolic hypertension. The adjusted relative risk of systolic hypertension in women born preterm was 1.72 (95% CI, 1.26-2.34; P<0.001) that of women born at term or post-term, but there was no significant difference in the risk of diastolic hypertension (adjusted relative risk, 1.60; 95% CI, 0.49-5.20). Conclusions-Young adult women born preterm display elevated systolic blood pressure and an increased risk of hypertension compared with peers born at term or post-term.

Place, publisher, year, edition, pages
WILEY, 2019
Keywords
high blood pressure, hypertension, prematurity, preterm birth, systolic blood pressure, women, young adult
National Category
Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-394172 (URN)10.1161/JAHA.119.012274 (DOI)000484577400017 ()31164036 (PubMedID)
Available from: 2019-10-04 Created: 2019-10-04 Last updated: 2019-10-04Bibliographically approved
Söderström, F., Normann, E., Holmström, G., Larsson, E., Ahlsson, F., Sindelar, R. & Ågren, J. (2019). Reduced rate of retinopathy of prematurity after implementing lower oxygen saturation targets.. Journal of Perinatology, 39, 409-414
Open this publication in new window or tab >>Reduced rate of retinopathy of prematurity after implementing lower oxygen saturation targets.
Show others...
2019 (English)In: Journal of Perinatology, ISSN 0743-8346, E-ISSN 1476-5543, Vol. 39, p. 409-414Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate an implementation of lower oxygen saturation targets with retinopathy of prematurity (ROP) as primary outcome, in infants at the lowest extreme of prematurity.

Study design: Retrospective cohort including infants born at 22-25 weeks of gestation in 2005-2015 (n = 325), comparing high (87-93%) and low (85-90%) targets; infants transferred early were excluded from the main analysis to avoid bias.

Results: Overall survival was 76% in high saturation era, and 69% in low saturation era (p = .17). Treatment-requiring ROP was less common in low saturation group (14% vs 28%, p < .05) with the most prominent difference in the most immature infants. Including deceased infants in the analysis, necrotizing enterocolitis was more frequent in low saturation era (21% vs 10%, p < .05).

Conclusions: Implementing lower saturation targets resulted in a halved incidence of treatment-requiring ROP; the most immature infants seem to benefit the most. An association between lower oxygenation and necrotizing enterocolitis cannot be excluded.

National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:uu:diva-368851 (URN)10.1038/s41372-018-0300-y (DOI)000459549600010 ()30617284 (PubMedID)
Available from: 2018-12-08 Created: 2018-12-08 Last updated: 2019-03-26Bibliographically approved
Serapio, S., Ahlsson, F., Larsson, A. & Kallak, T. K. (2019). Second Trimester Maternal Leptin Levels Are Associated with Body Mass Index and Gestational Weight Gain but not Birth Weight of the Infant. Hormone Research in Paediatrics, 92(2), 106-114
Open this publication in new window or tab >>Second Trimester Maternal Leptin Levels Are Associated with Body Mass Index and Gestational Weight Gain but not Birth Weight of the Infant
2019 (English)In: Hormone Research in Paediatrics, ISSN 1663-2818, E-ISSN 1663-2826, Vol. 92, no 2, p. 106-114Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Obesity is increasing among the pregnant population. Leptin has an important role in the regulation of energy balance and hunger. The aim of this study was to investigate the association between maternal leptin levels with maternal obesity, gestational weight gain (GWG), single nucleotide polymorphisms (SNPs) within the leptin gene, and the age-adjusted birth weight of the child.

MATERIAL AND METHODS: Maternal leptin levels (n = 740) and SNPs (n = 504) were analyzed in blood samples taken within the Uppsala Biobank of Pregnant women at pregnancy weeks 16-19.

RESULTS: Maternal leptin levels differed significantly between body mass index (BMI) groups. Normal weight women had the lowest median leptin levels and levels increased with each BMI group. Leptin SNP genotype was not associated with leptin levels or BMI. There was also no association between maternal leptin levels and age-adjusted birth weight of the child except for a negative association between leptin levels and birth weight in the morbid obese group.

DISCUSSION/CONCLUSION: Maternal BMI was identified as the best positive explanatory factor for maternal leptin levels. Leptin was a strong positive explanatory factor for GWG. Birth weight of children of uncomplicated pregnancies was, however, dependent on maternal height, BMI, GWG, and parity but not leptin levels, except for in morbid obese women where a negative association between maternal leptin levels and birth weight was found. We speculate that this indicates altered placental function, not manifested in pregnancy complication. We conclude that maternal leptin levels do not affect the birth weight of the child more than BMI, GWG, and parity.

Place, publisher, year, edition, pages
S. Karger, 2019
Keywords
Birth weight, Intrauterine growth, Maternal leptin, Obesity
National Category
Clinical Laboratory Medicine
Identifiers
urn:nbn:se:uu:diva-396318 (URN)10.1159/000503422 (DOI)000507907900005 ()31655800 (PubMedID)
Available from: 2019-11-02 Created: 2019-11-02 Last updated: 2020-03-05Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8413-9274

Search in DiVA

Show all publications