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Publications (10 of 31) 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
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
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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
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
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.
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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
Johnsson, I. W., Naessén, T., Ahlsson, F. & Gustafsson, J. (2018). High birth weight was associated with increased radial artery intima thickness but not with other investigated cardiovascular risk factors in adulthood. Acta Paediatrica, 12, 2152-2157
Open this publication in new window or tab >>High birth weight was associated with increased radial artery intima thickness but not with other investigated cardiovascular risk factors in adulthood
2018 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 12, p. 2152-2157Article in journal (Refereed) Published
Abstract [en]

AIM: This study investigated whether a high birth weight was associated with increased risk factors for cardiovascular disease when Swedish adults reached 34-40.

METHODS: We studied 27 subjects born at Uppsala University Hospital in 1975-1979, weighing at least 4500 g, and compared them with 27 controls selected by the Swedish National Board of Welfare with birth weights within ±1 standard deviations scores and similar ages and gender. The study included body mass index (BMI), blood pressure, lipid profile, haemoglobin A1c (HbA1c), C-reactive protein (CRP) and high-frequency ultrasound measurements of intima-media thickness, intima thickness (IT) and intima:media ratio of the carotid and radial arteries.

RESULTS: Subjects with a high birth weight did not differ from controls with regard to BMI, blood pressure, lipid profile, high-sensitivity CRP, HbA1c or carotid artery wall dimensions. However, their radial artery intima thickness was 37% greater than the control group and their intima:media ratio was 44% higher.

CONCLUSION: Our findings indicate that a high birth weight was associated with increased radial artery intima thickness, but not with other investigated cardiovascular risk factors, at 34-40 years of age. The clinical implications of these findings should be investigated further, especially in subjects born with a very high birth weight.

Keywords
Cardiovascular risk factors, High birth weight, Intima thickness, Intima:media ratio, Large for gestational age
National Category
Pediatrics Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-364690 (URN)10.1111/apa.14414 (DOI)000449638100022 ()29791055 (PubMedID)
Funder
Novo Nordisk
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2019-01-22Bibliographically approved
Zamir, I., Tornevi, A., Abrahamsson, T., Ahlsson, F., Engström, E., Hallberg, B., . . . Domellöf, M. (2018). Hyperglycemia in Extremely Preterm Infants Insulin Treatment, Mortality and Nutrient Intakes. Journal of Pediatric Surgery Case Reports, 200, 104-110
Open this publication in new window or tab >>Hyperglycemia in Extremely Preterm Infants Insulin Treatment, Mortality and Nutrient Intakes
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2018 (English)In: Journal of Pediatric Surgery Case Reports, ISSN 0022-3476, E-ISSN 2213-5766, Vol. 200, p. 104-110Article in journal (Refereed) Published
Abstract [en]

Objective To explore the prevalence of hyperglycemia and the associations between nutritional intakes, hyperglycemia, insulin treatment, and mortality in extremely preterm infants. Study design Prospectively collected data from the Extremely Preterm Infants in Sweden Study (EXPRESS) was used in this study and included 580 infants born <27 gestational weeks during 2004-2007. Available glucose measurements (n = 9850) as well as insulin treatment and nutritional data were obtained retrospectively from hospital records for the first 28 postnatal days as well as 28- and 70-day mortality data. Results Daily prevalence of hyperglycemia >180 mg/dL (10 mmol/L) of up to 30% was observed during the first 2 postnatal weeks, followed by a slow decrease in its occurrence thereafter. Generalized additive model analysis showed that increasing parenteral carbohydrate supply with 1 g/kg/day was associated with a 1.6% increase in glucose concentration (P < .001). Hyperglycemia was associated with more than double the 28-day mortality risk (P< .01). In a logistic regression model, insulin treatment was associated with lower 28- and 70-day mortality when given to infants with hyperglycemia irrespective of the duration of the hyperglycemic episode (P< .05). Conclusions Hyperglycemia is common in extremely preterm infants throughout the first postnatal month. Glucose infusions seem to have only a minimal impact on glucose concentrations. In the EXPRESS cohort, insulin treatment was associated with lower mortality in infants with hyperglycemia. Current practices of hyperglycemia treatment in extremely preterm infants should be reevaluated and assessed in randomized controlled clinical trials.

Place, publisher, year, edition, pages
MOSBY-ELSEVIER, 2018
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-389884 (URN)10.1016/j.jpeds.2018.03.049 (DOI)000442390400020 ()29731360 (PubMedID)
Funder
Swedish Research Council, 2016-02095Västerbotten County Council, VLL-640871
Available from: 2019-07-31 Created: 2019-07-31 Last updated: 2019-07-31Bibliographically approved
Derraik, J. G. B., Lundgren, M., Cutfield, W. S. & Ahlsson, F. (2017). Association Between Preterm Birth and Lower Adult Height in Women. American Journal of Epidemiology, 185(1), 48-53
Open this publication in new window or tab >>Association Between Preterm Birth and Lower Adult Height in Women
2017 (English)In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 185, no 1, p. 48-53Article in journal (Refereed) Published
Abstract [en]

We examined whether being born preterm was associated with changes in adult anthropometry in women. We assessed data on 201,382 women (born in 1973-1988) from the Swedish Birth Register. The mean age was 26.0 years. Of the women in our cohort, 663 were born very preterm (< 32 weeks of gestation), 8,247 were born moderately preterm (at least 32 weeks but < 37 weeks), and 192,472 were born at term (37-41 weeks). Subgroup analyses were carried out among siblings and also after adjustment for maternal anthropometric data. Statistical tests were 2-sided. Decreasing gestational age was associated with lower height (-1.1 mm per week of gestation; P < 0.0001), so that women who were born very preterm were on average 12 mm shorter than women who were born moderately preterm (P < 0.0001) and 17 mm shorter than women born at term (P < 0.0001). Compared with women who were born at term, those who were born very preterm had 2.9 times higher odds of short stature (< 155.4 cm), and those born moderately preterm had 1.43 times higher odds. Subgroup analyses showed no differences between women born moderately preterm and those born at term but accentuated differences from women born very preterm. Among siblings (n = 2,388), very preterm women were 23 mm shorter than those born at term (P = 0.003), with a 20-mm difference observed in subgroup analyses (n = 27,395) that were adjusted for maternal stature (P < 0.001). A shorter final height was associated with decreasing gestational age, and this association was particularly marked in women born very preterm.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS INC, 2017
Keywords
adult, females, gestational age, premature birth, preterm, siblings, stature, women
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-319677 (URN)10.1093/aje/kww116 (DOI)000397232100007 ()27941067 (PubMedID)
Available from: 2017-04-07 Created: 2017-04-07 Last updated: 2017-11-29Bibliographically approved
Späth, C., Sjöström, E. S., Ahlsson, F., Ågren, J. & Domellöf, M. (2017). Sodium supply influences plasma sodium concentration and the risks of hyper- and hyponatremia in extremely preterm infants. Pediatric Research, 81(3), 455-460
Open this publication in new window or tab >>Sodium supply influences plasma sodium concentration and the risks of hyper- and hyponatremia in extremely preterm infants
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2017 (English)In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 81, no 3, p. 455-460Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Hyper- and hyponatremia occur frequently in extremely preterm infants. Our purpose was to investigate plasma sodium (P-Na) concentrations, the incidence of hyper and hyponatremia, and the impact of possible predisposing factors in extremely preterm infants. METHODS: In this observational study, we analyzed data from the EXtremely PREterm (< 27wk.) infants in Sweden Study (EXPRESS, n = 707). Detailed nutritional, laboratory, and weight data were collected retrospectively from patient records. RESULTS: Mean +/- SD P-Na increased from 135.5 +/- 3.0 at birth to 144.3 +/- 6.1 mmol/l at a postnatal age of 3 d and decreased thereafter. Fifty percent of infants had hypernatremia (P-Na > 145 mmol/l) during the first week of life while 79% displayed hyponatremia (P-Na < 135 mmol/l) during week 2. Initially, the main sodium sources were blood products and saline injections/infusions, gradually shifting to parenteral and enteral nutrition towards the end of the first week. The major deter, minant of P-Na and the risks of hyper- and hyponatremia was sodium supply. Fluid volume provision was associated with postnatal weight change but not with P-Na. CONCLUSION: The supply of sodium, rather than fluid volume, is the major factor determining P-Na concentrations and the risks of hyper- and hyponatremia.

Place, publisher, year, edition, pages
NATURE PUBLISHING GROUP, 2017
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-320874 (URN)10.1038/pr.2016.264 (DOI)000396297000016 ()27935901 (PubMedID)
Available from: 2017-04-26 Created: 2017-04-26 Last updated: 2017-04-26Bibliographically approved
Derraik, J. G. B., Lundgren, M., Cutfield, W. S. & Ahlsson, F. (2016). Body Mass Index, Overweight, and Obesity in Swedish Women Born Post-term. Paediatric and Perinatal Epidemiology, 30(4), 320-324
Open this publication in new window or tab >>Body Mass Index, Overweight, and Obesity in Swedish Women Born Post-term
2016 (English)In: Paediatric and Perinatal Epidemiology, ISSN 0269-5022, E-ISSN 1365-3016, Vol. 30, no 4, p. 320-324Article in journal (Refereed) Published
Abstract [en]

BackgroundThere is increasing evidence that post-term birth (42 weeks of gestation) is associated with adverse long-term outcomes. We assessed whether women born post-term displayed increased risk of overweight and obesity in adulthood. MethodsData were collected at first antenatal visit (similar to 10-12 weeks of gestation) on singleton Swedish women aged 18 years in 1991-2009 (mean age 26.1 years), who were born post-term (n = 27 153) or at term (37-41 weeks of gestation; n = 184 245). Study outcomes were evaluated for continuous associations with gestational age. Stratified analyses were carried out comparing women born post-term or at term. Analyses were also run with a 2-week buffer between groups to account for possible errors in gestational age estimation, comparing women born very post-term (43 weeks of gestation; n = 5761) to those born within a narrower term window (38-40 weeks of gestation; n = 130 110). ResultsIncreasing gestational age was associated with greater adult weight and body mass index (BMI). Stratified analyses showed that women born post-term were 0.5 kg heavier and had BMI 0.2 kg/m(2) greater than those born at term. Differences were more marked between women born very post-term (43 weeks) vs. a narrower term group (38-40 weeks): 1.0 kg and 0.3 kg/m(2). The adjusted relative risks of overweight/obesity and obesity in women born very post-term were 1.13 and 1.12 times higher, respectively, than in those born at term. ConclusionsPost-term birth is associated with greater BMI and increased risk of overweight and obesity in adulthood, particularly among women born 43 weeks of gestation.

Keywords
adult, body mass index, females, gestational age, obesity, overweight, prolonged gestation
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-299857 (URN)10.1111/ppe.12292 (DOI)000378638300003 ()27016177 (PubMedID)
Available from: 2016-07-29 Created: 2016-07-28 Last updated: 2017-11-28Bibliographically approved
Zamir, I., Sjöström, E. S., Abrahamsson, T., Ahlsson, F., Hallberg, B., Pupp, I., . . . Domellöf, M. (2016). Early-life hyperglycemia in extremely preterm infants affects neurodevelopment at 6 years of age. European Journal of Pediatrics, 175(11), 1440-1440
Open this publication in new window or tab >>Early-life hyperglycemia in extremely preterm infants affects neurodevelopment at 6 years of age
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2016 (English)In: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 175, no 11, p. 1440-1440Article in journal, Meeting abstract (Refereed) Published
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-315011 (URN)000390040700165 ()
Available from: 2017-02-08 Created: 2017-02-08 Last updated: 2017-11-29Bibliographically approved
Organisations
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ORCID iD: ORCID iD iconorcid.org/0000-0002-8413-9274

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