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Palm, A., Högberg, U., Olofsson, N., Skalkidou, A. & Danielsson, I. (2020). No Differences in Health Outcomes After Routine Inquiry About Violence Victimization in Young Women: A Randomized Controlled Study in Swedish Youth Health Centers. Journal of Interpersonal Violence, 35(1-2), 77-99
Open this publication in new window or tab >>No Differences in Health Outcomes After Routine Inquiry About Violence Victimization in Young Women: A Randomized Controlled Study in Swedish Youth Health Centers
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2020 (English)In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518, Vol. 35, no 1-2, p. 77-99Article in journal (Refereed) Published
Abstract [en]

Youth is a period in life when the risk of violence victimization is high and association between victimization and ill health is well established. Youth rarely reveal violence victimization to health professionals if not directly asked but favor health professionals asking about victimization. The study’s primary aim was to examine health outcomes in young women being routinely asked about violence victimization and offered subsequent support, compared with controls, at 12-month follow-up. Secondary aims were to examine to what extent routine inquiry altered the consultation and re-victimization rates during the study period. A randomized controlled intervention study was conducted at Swedish youth health centers. Participants assigned to the intervention group were asked structured questions about violence. Victimized participants received empowering strategies and were offered further counseling. Participants in the control group completed questionnaires about victimization after the visit. Both groups answered questions about sociodemographics and health, constructed from validated instruments. A questionnaire was administered to all participants 12 months after baseline. Of 1,445 eligible young women, 1,051 (73%) participated, with 54% of the participants completing the 12-month follow-up. Lifetime violence victimization was reported by 53% in the intervention group and 60% in the control group, ns. There were no significant differences in health outcomes, between baseline and 12-month follow-up, within either group or between groups. Re-victimization rates were 16% in the intervention group and 12% in the control group, ns. Of victimized young women in the intervention group, 14% wanted and received further counseling. Routine inquiry about violence victimization and empowering strategies were feasible within ordinary consultations at youth health centers but did not demonstrate improved health outcomes at 12-month follow-up compared with controls. Questions about violence led to a high degree of disclosure, and 14% of victimized young women in the intervention group received further counseling as a result.

Keywords
violence victim, youth, screening, health, randomized controlled trial, treatment outcome
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-307391 (URN)10.1177/0886260516681878 (DOI)000503281100004 ()27909178 (PubMedID)
Funder
The Swedish Crime Victim Compensation and Support Authority
Note

Title in thesis list of papers: No differences in health outcomes after routine inquiry into violence victimization in young women – A randomized controlled study in Swedish youth health centers

Available from: 2016-11-14 Created: 2016-11-14 Last updated: 2020-02-25Bibliographically approved
Kullinger, M., Granfors, M., Kieler, H. & Skalkidou, A. (2019). Adherence to Swedish national pregnancy dating guidelines and management of discrepancies between pregnancy dating methods: a survey study. Reproductive Health, 16, Article ID 95.
Open this publication in new window or tab >>Adherence to Swedish national pregnancy dating guidelines and management of discrepancies between pregnancy dating methods: a survey study
2019 (English)In: Reproductive Health, ISSN 1742-4755, E-ISSN 1742-4755, Vol. 16, article id 95Article in journal (Refereed) Published
Abstract [en]

Background. Swedish national guidelines for pregnancy dating were published in 2010. Follow-up is needed to assess adherence and to identify whether any clinical topics are not covered in the guidelines.

Methods. All units in Sweden that performed ultrasound-based pregnancy dating were asked to complete a web-based questionnaire comprising multiple-response questions and commentary fields. Information was collected regarding baseline information, current and previous clinical practice, and management of discrepancies between last-menstrual-period- and ultrasound-based methods for pregnancy dating.

Results. The response rate was 88% (38/43 units). Half of the units offered first-trimester ultrasound to all pregnant women. However, contrary to the guidelines, the crown–rump length was not used for ultrasound-based pregnancy dating in most units. Ultrasound-based pregnancy dating was performed only if the biparietal diameter was between 21 and 55 mm. The methods for management of discrepancies between methods for pregnancy dating varied widely.

Conclusions. The units reported high adherence to national guidelines, except for early pregnancy dating, for which many units followed unwritten or informal guidelines. The management of discrepancies between last-menstrual-period-based and ultrasound-based estimated day of delivery varied widely. These findings emphasize the need for regular updating of national written guidelines and efforts to improve their implementation in all units.

National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-345956 (URN)10.1186/s12978-019-0760-3 (DOI)000474617600001 ()31272510 (PubMedID)
Projects
Discrepancy between pregnancy dating methods – correlates and outcomes
Available from: 2018-03-13 Created: 2018-03-13 Last updated: 2019-08-21Bibliographically approved
Cato, K., Sylvén, S. M., Georgakis, M. K., Kollia, N., Rubertsson, C. & Skalkidou, A. (2019). Antenatal depressive symptoms and early initiation of breastfeeding in association with exclusive breastfeeding six weeks postpartum: a longitudinal population-based study. BMC Pregnancy and Childbirth, 19, Article ID 49.
Open this publication in new window or tab >>Antenatal depressive symptoms and early initiation of breastfeeding in association with exclusive breastfeeding six weeks postpartum: a longitudinal population-based study
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2019 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 19, article id 49Article in journal (Refereed) Published
Abstract [en]

Background

Depressive symptoms negatively impact on breastfeeding duration, whereas early breastfeeding initiation after birth enhances the chances for a longer breastfeeding period. Our aim was to investigate the interplay between depressive symptoms during pregnancy and late initiation of the first breastfeeding session and their effect on exclusive breastfeeding at six weeks postpartum.

Methods

In a longitudinal study design, web-questionnaires including demographic data, breastfeeding information and the Edinburgh Postnatal Depression Scale (EPDS) were completed by 1217 women at pregnancy weeks 17–20, 32 and/or at six weeks postpartum. A multivariable logistic regression model was fitted to estimate the effect of depressive symptoms during pregnancy and the timing of the first breastfeeding session on exclusive breastfeeding at six weeks postpartum.

Results

Exclusive breastfeeding at six weeks postpartum was reported by 77% of the women. Depressive symptoms during pregnancy (EPDS> 13); (OR:1.93 [1.28–2.91]) and not accomplishing the first breastfeeding session within two hours after birth (OR: 2.61 [1.80–3.78]), were both associated with not exclusively breastfeeding at six weeks postpartum after adjusting for identified confounders. Τhe combined exposure to depressive symptoms in pregnancy and late breastfeeding initiation was associated with an almost 4-fold increased odds of not exclusive breastfeeding at six weeks postpartum.

Conclusions

Women reporting depressive symptoms during pregnancy seem to be more vulnerable to the consequences of a postponed first breastfeeding session on exclusive breastfeeding duration. Consequently, women experiencing depressive symptoms may benefit from targeted breastfeeding support during the first hours after birth.

Keywords
Antenatal depression, Breastfeeding initiation, Exclusive breastfeeding, Breastfeeding discontinuation
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-377343 (URN)10.1186/s12884-019-2195-9 (DOI)000457123700001 ()30696409 (PubMedID)
Funder
Swedish Research CouncilMarianne and Marcus Wallenberg Foundation
Available from: 2019-02-25 Created: 2019-02-25 Last updated: 2019-02-25Bibliographically approved
Skoglund, C., Kallner, H. K., Skalkidou, A., Wikström, A.-K., Lundin, C., Hesselman, S., . . . Sundström Poromaa, I. (2019). Association of Attention-Deficit/Hyperactivity Disorder With Teenage Birth Among Women and Girls in Sweden. JAMA NETWORK OPEN, 2(10), Article ID e1912463.
Open this publication in new window or tab >>Association of Attention-Deficit/Hyperactivity Disorder With Teenage Birth Among Women and Girls in Sweden
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2019 (English)In: JAMA NETWORK OPEN, ISSN 2574-3805, Vol. 2, no 10, article id e1912463Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE Attention-deficit/hyperactivity disorder (ADHD) is associated with a plethora of adverse health outcomes throughout life. While Swedish specialized youth clinics have carefully and successfully targeted risk of unplanned pregnancies in adolescents, important risk groups, such as women and girls with ADHD, might not be identified or appropriately assisted by these interventions. OBJECTIVES To determine whether women and girls with ADHD are associated with increased risk of teenage birth compared with their unaffected peers and to examine the association of ADHD with risk factors for adverse obstetric and perinatal outcomes, such as smoking, underweight or overweight, and substance use disorder. DESIGN, SETTING, AND PARTICIPANTS This nationwide cohort study included data from 6 national longitudinal population-based registries in Sweden. All nulliparous women and girls who gave birth in Sweden between January 1, 2007, and December 31, 2014, were included. Data analyses were conducted from October 7, 2018, to February 8, 2019. EXPOSURES Women and girls treated with stimulant or nonstimulant medication for ADHD (Anatomic Therapeutic Chemical classification code N06BA) in the Swedish Prescribed Drug Register between July 1, 2005, and December 31, 2014. MAIN OUTCOMES AND MEASURES Maternal age at birth. Secondary outcome measures were body mass index, smoking habits, and psychiatric comorbidities. RESULTS Among 384 103 nulliparous women and girls aged 12 to 50 years who gave birth between 2007 and 2014 included in the study, 6410 (1.7%) (mean [SD] age, 25.0 [5.5] years) were identified as having ADHD. The remaining 377 693 women and girls without ADHD (mean [SD] age, 28.5 [5.1] years) served as the control group. Teenage deliveries were more common among women and girls with ADHD than among women and girls without ADHD (15.3% vs 2.8%; odds ratio [OR], 6.23 [95% CI, 5.80-6.68]). Compared with women and girls without ADHD, those with ADHD were more likely to present with risk factors for adverse obstetric and perinatal outcomes, including smoking during the third trimester (OR, 6.88 [95% CI, 6.45-7.34]), body mass index less than 18.50 (OR, 1.29 [95% CI, 1.12-1.49]), body mass index more than 40.00 (OR, 2.01 [95% CI, 1.60-2.52]), and alcohol and substance use disorder (OR, 20.25 [95% CI, 18.74-21.88]). CONCLUSIONS AND RELEVANCE This study found that women and girls with ADHD were associated with an increased risk of giving birth as teenagers compared with their unaffected peers. The results suggest that standard of care for women and girls with ADHD should include active efforts to prevent teenage pregnancies.

Place, publisher, year, edition, pages
AMER MEDICAL ASSOC, 2019
National Category
Psychiatry Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-400016 (URN)10.1001/jamanetworkopen.2019.12463 (DOI)000497997100014 ()31577361 (PubMedID)
Available from: 2019-12-19 Created: 2019-12-19 Last updated: 2019-12-27Bibliographically approved
Henriksson, H. E., Malavaki, C., Bränn, E., Drainas, V., Lager, S., Iliadis, S. I., . . . Skalkidou, A. (2019). Blood plasma metabolic profiling of pregnant women with antenatal depressive symptoms. Translational Psychiatry, 9, Article ID 204.
Open this publication in new window or tab >>Blood plasma metabolic profiling of pregnant women with antenatal depressive symptoms
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2019 (English)In: Translational Psychiatry, ISSN 2158-3188, E-ISSN 2158-3188, Vol. 9, article id 204Article in journal (Refereed) Published
Abstract [en]

Antenatal depression affects similar to 9-19% of pregnant women and can exert persistent adverse effects on both mother and child. There is a need for a deeper understanding of antenatal depression mechanisms and the development of tools for reliable diagnosis and early identification of women at high risk. As the use of untargeted blood metabolomics in the investigation of psychiatric and neurological diseases has increased substantially, the main objective of this study was to investigate whether untargeted gas chromatography-mass spectrometry (GC-MS) plasma metabolomics in 45 women in late pregnancy, residing in Uppsala, Sweden, could indicate metabolic differences between women with and without depressive symptoms. Furthermore, seasonal differences in the metabolic profiles were explored. When comparing the profiles of cases with controls, independently of season, no differences were observed. However, seasonal differences were observed in the metabolic profiles of control samples, suggesting a favorable cardiometabolic profile in the summer vs. winter, as indicated by lower glucose and sugar acid concentrations and lactate to pyruvate ratio, and higher abundance of arginine and phosphate. Similar differences were identified between cases and controls among summer pregnancies, indicating an association between a stressed metabolism and depressive symptoms. No depression-specific differences were apparent among depressed and non-depressed women, in the winter pregnancies; this could be attributed to an already stressed metabolism due to the winter living conditions. Our results provide new insights into the pathophysiology of antenatal depression, and warrant further investigation of the use of metabolomics in antenatal depression in larger cohorts.

National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-381425 (URN)10.1038/s41398-019-0546-y (DOI)000483953900001 ()31444321 (PubMedID)
Funder
Swedish Research Council, 523-2014-2342Swedish Society of Medicine, SLS-250581Marianne and Marcus Wallenberg Foundation, MMW2011.0115
Available from: 2019-04-09 Created: 2019-04-09 Last updated: 2019-10-09Bibliographically approved
Wikman, A., Axfors, C., Iliadis, S. I., Cox, J., Fransson, E. & Skalkidou, A. (2019). Characteristics of women with different perinatal depression trajectories. Journal of Neuroscience Research
Open this publication in new window or tab >>Characteristics of women with different perinatal depression trajectories
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2019 (English)In: Journal of Neuroscience Research, ISSN 0360-4012, E-ISSN 1097-4547Article in journal (Refereed) Epub ahead of print
Abstract [en]

Maternal perinatal depression (PND), a common mental disorder with a prevalence of over 10%, is associated with long-term health risks for both mothers and offspring. This study aimed at describing characteristics related to background and lifestyle, pregnancy, delivery, and postpartum of different PND trajectories defined according to the onset of depressive symptoms. Participants were drawn from a large population-based cohort study in Uppsala, Sweden (n = 2,466). Five trajectory groups of depressive symptom onset were created using the Edinburgh Postnatal Depression Scale ≥13 (pregnancy) or ≥12 points (postpartum): (a) healthy (60.6%), (b) pregnancy depression (8.5%), (c) early postpartum onset (10.9%), (d) late postpartum onset (5.4%), and (e) chronic depression (14.6%). In multinomial logistic regressions, the associations between trajectories and the included characteristics were tested using the healthy trajectory as reference. Background characteristics (younger age, lower education, unemployment) were primarily associated with pregnancy depression and chronic depression. Characteristics associated with all PND trajectories were smoking prior to pregnancy, migraine, premenstrual mood symptoms, intimate partner violence, interpersonal trauma, negative delivery expectations, pregnancy nausea, and symphysiolysis. Nulliparity, instrumental delivery, or a negative delivery experience was associated with early postpartum onset. Postpartum factors (e.g., infantile colic, lack of sleep, low partner support, and bonding difficulties) were associated with early and late postpartum onset together with chronic depression. The findings suggest that different PND trajectories have divergent characteristics, which could be used to create individualized treatment options. To find the most predictive characteristics for different PND trajectories, studies with even larger and more diverse samples are warranted.

Keywords
depression, depressive disorder, mental disorders, mothers, postpartum, pregnancy, self-reports
National Category
Obstetrics, Gynecology and Reproductive Medicine Psychiatry
Identifiers
urn:nbn:se:uu:diva-378699 (URN)10.1002/jnr.24390 (DOI)30723972 (PubMedID)
Available from: 2019-03-08 Created: 2019-03-08 Last updated: 2019-04-11Bibliographically approved
Axfors, C., Bränn, E., Henriksson, H. E., Hellgren, C., Kallak, T. K., Fransson, E., . . . Skalkidou, A. (2019). Cohort profile: the Biology, Affect, Stress, Imaging and Cognition (BASIC) study on perinatal depression in a population-based Swedish cohort. BMJ Open, 9(10), Article ID e031514.
Open this publication in new window or tab >>Cohort profile: the Biology, Affect, Stress, Imaging and Cognition (BASIC) study on perinatal depression in a population-based Swedish cohort
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 10, article id e031514Article in journal (Refereed) Published
Abstract [en]

PURPOSE: With the population-based, prospective Biology, Affect, Stress, Imaging and Cognition (BASIC) cohort, we aim to investigate the biopsychosocial aetiological processes involved in perinatal depression (PND) and to pinpoint its predictors in order to improve early detection.

PARTICIPANTS: From September 2009 to November 2018, the BASIC study at Uppsala University Hospital, Sweden, has enrolled 5492 women, in 6478 pregnancies, of which 46.3% first-time pregnancies and with an average age of 31.5 years. After inclusion around gestational week 16-18, participants are followed-up with data collection points around gestational week 32, at childbirth, as well as three times postpartum: after 6 weeks, 6 months and 1 year. At the last follow-up, 70.8% still remain in the cohort.

FINDINGS TO DATE: In addition to internet-based surveys with self-report instruments, participants contribute with biological samples, for example, blood samples (maternal and from umbilical cord), biopsies (umbilical cord and placenta) and microbiota samples. A nested case-control subsample also takes part in cognitive and emotional tests, heart rate variability tests and bioimpedance tests. Subprojects have identified various correlates of PND of psychological and obstetric origin in addition to factors of the hypothalamic-pituitary-adrenal axis and immune system.

FUTURE PLANS: In parallel with the completion of data collection (final follow-up November 2019), BASIC study data are currently analysed in multiple subprojects. Since 2012, we are conducting an ongoing follow-up study on the participants and their children up to 6 years of age (U-BIRTH). Researchers interested in collaboration may contact Professor Alkistis Skalkidou (corresponding author) with their request to be considered by the BASIC study steering committee.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
cohort study, mother-child relations, pituitary-adrenal system, postpartum depression, pregnancy, psychoneuroimmunology
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-404667 (URN)10.1136/bmjopen-2019-031514 (DOI)31641004 (PubMedID)
Funder
Swedish Research Council, 523-2014-2342Swedish Research Council, 523-2014-07605Swedish Research Council, 521-2013-2339Göran Gustafsson Foundation for promotion of scientific research at Uppala University and Royal Institute of TechnologyMarianne and Marcus Wallenberg FoundationStiftelsen Söderström - Königska sjukhemmetSwedish Society of MedicineForte, Swedish Research Council for Health, Working Life and WelfareFredrik och Ingrid Thurings Stiftelse
Available from: 2020-02-25 Created: 2020-02-25 Last updated: 2020-03-27Bibliographically approved
Öberg, M., Skalkidou, A. & Heimer, G. (2019). Experiences of sexual violence among women seeking services at a family planning unit in Sweden. Upsala Journal of Medical Sciences, 124(2), 135-139
Open this publication in new window or tab >>Experiences of sexual violence among women seeking services at a family planning unit in Sweden
2019 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 124, no 2, p. 135-139Article in journal (Refereed) Published
Abstract [en]

Background: Experiences of sexual violence among women can lead to ill health and increase the risk of lifetime co-occurrence of violence. Identifying risk factors and victims facilitates development of effective programmes for treatment and prevention of additional violence. The primary aim of this study was to assess the prevalence and correlates of sexual violence experiences among women seeking care at a family planning unit in Sweden. A secondary aim was to examine associations between sexual violence and other types of violence.Methods: Women (n=1226) seeking services at a family planning unit, Uppsala University Hospital, Sweden, answered a questionnaire and were interviewed about experiences of sexual violence. Bivariate associations were examined using the chi-square test.Results: Experiences of sexual violence were reported by 27% of the participants, of which 57% were exposed when they were younger than 18 years old. Women with experiences of sexual violence were more likely to have lower education (P=0.024), were students or without occupation (P=0.037), and were not in a current relationship (P<0.001). Women with experiences of non-partner sexual violence were more likely to have experiences of intimate partner violence (P<0.001).Conclusion: Prevalence of sexual violence was high among the respondents. Many women were young when they were exposed to violence, and lifetime co-occurrence of violence was common among women with experiences of non-partner sexual violence.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
Keywords
Intimate partner violence, polyvictimization, psychological violence, physical violence, revictimization, sexual violence
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-398724 (URN)10.1080/03009734.2019.1604587 (DOI)000471416100001 ()31081728 (PubMedID)
Available from: 2019-12-10 Created: 2019-12-10 Last updated: 2019-12-10Bibliographically approved
Breedh, J., Comasco, E., Hellgren, C., Papadopoulos, F. C., Skalkidou, A. & Sundström Poromaa, I. (2019). Hypothalamic-pituitary-adrenal axis responsiveness, startle response, and sensorimotor gating in late pregnancy. Psychoneuroendocrinology, 106, 1-8
Open this publication in new window or tab >>Hypothalamic-pituitary-adrenal axis responsiveness, startle response, and sensorimotor gating in late pregnancy
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2019 (English)In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 106, p. 1-8Article in journal (Refereed) Published
Abstract [en]

During pregnancy, the hypothalamic-pituitary-adrenal (HPA) axis, the main regulator of the stress response, undergoes dramatic changes. The acoustic startle response (ASR) and the prepulse inhibition (PPI) of the startle response are neurophysiological research tools and objective measures of an individual's response to an emotional context or stressor. The ASR and PPI are influenced by psychiatric diseases characterized by anxiety symptoms and are sensitive to cortisol. Hence, the ASR and the PPI can be used to investigate the effects of pregnancy-induced endocrine changes and their contribution to affective disorders. The present study sought to investigate the association between measures of HPA-axis responsiveness, startle reactivity and sensorimotor gating during pregnancy that to date remains unknown. The eye-blink component of the ASR, and its prepulse inhibition, were measured in 107 late third trimester pregnant women. Saliva samples were collected to assess the cortisol awakening response (CAR), a measure of HPA-axis activity. Blood was sampled to measure serum levels of cortisol, cortisone and the cortisone to cortisol ratio. Ongoing anxiety disorders, sleep duration, smoking, and age were considered as potential confounders in the statistical analyses. CAR reactivity, measured as area under the curve (AUC) increase and above baseline, was positively associated with baseline startle magnitude [Cohen's d = 0.27; F (1, 105) = 4.99; p = 0.028, and Cohen's d = 0.30; F (1, 105) = 6.25; p = 0.014, respectively] as well as PPI at 86 dB [Cohen's d = 0.29; F (1, 105) = 5.93; p = 0.017; and Cohen's d = 0.34; F (1, 105) = 8.38; p = 0.005, respectively]. The observed positive correlation between startle magnitude in pregnant women and greater increase in cortisol during the awakening response may be interpreted as heightened neurophysiological reactivity, likely associated with dysregulation of the stress system.

Keywords
AUC, CAR, Cortisol, Pregnancy, Sensorimotor gating, Startle response
National Category
Endocrinology and Diabetes Neurosciences Psychiatry
Identifiers
urn:nbn:se:uu:diva-381815 (URN)10.1016/j.psyneuen.2019.03.008 (DOI)000474678300001 ()30927623 (PubMedID)
Funder
Swedish Research Council, 521-2013-2339Marianne and Marcus Wallenberg Foundation, MMW2011.0115The Swedish Medical Association, SLS-250581Swedish Society of Medicine, SLS-331991Swedish Research Council, 2015-00495EU, FP7, Seventh Framework Programme, INCA 600398
Available from: 2019-04-15 Created: 2019-04-15 Last updated: 2019-08-16Bibliographically approved
Bränn, E., Edvinsson, Å., Rostedt Punga, A., Sundström Poromaa, I. & Skalkidou, A. (2019). Inflammatory and anti-inflammatory markers in plasma: from late pregnancy to early postpartum. Scientific Reports, 9, Article ID 1863.
Open this publication in new window or tab >>Inflammatory and anti-inflammatory markers in plasma: from late pregnancy to early postpartum
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2019 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, article id 1863Article in journal (Refereed) Published
Abstract [en]

During pregnancy, the woman's body undergoes tremendous changes in immune system adaptation. The immunological shifts that occur in pregnancy can partially be explained by alterations in hormonal levels. Furthermore, during pregnancy, many autoimmune diseases go into remission, only to flare again in the early postpartum period. Given these important changes in the clinical course of a number of autoimmune disorders, surprisingly little has been done to investigate the inflammatory profile changes across pregnancy and the postpartum period. Thus, the aim of this study was to describe how inflammatory and anti-inflammatory markers change from late pregnancy to the early postpartum period, using a multiplexed assay consisting of both well-known as well as exploratory proteins. Two-hundred-and-ninety women were included in this study and donated a total of 312 blood samples; 198 in late pregnancy (similar to gw38) and 114 in the postpartum period (similar to w8). The plasma blood samples were analyzed for 92 immune system related protein markers using Proseek Multiplex Inflammation I panel, a high-sensitivity assay based on proximity extension assay technology. Fifty-six inflammatory and anti-inflammatory markers were significantly different between pregnancy and the postpartum, of which 50 survived corrections for multiple comparisons. Out of these 50 markers, 41 decreased from pregnancy to postpartum, while the remaining 9 increased in the postpartum period. The top five markers with the greatest decrease in the postpartum period were Leukemia inhibitory factor receptor (LIF-R), Latency-associated peptide Transforming growth factor beta-1 (LAP TGF-beta-1), C-C motif chemokine 28 (CCL28), Oncostatin M (OSM) and Fibroblast growth factor 21 (FGF21). Top three markers that increased in the postpartum period were Tumor necrosis factor ligand superfamily member 11 (TRANCE), Tumor necrosis factor ligand superfamily member 12 (TWEAK), and C-C motif chemokine/Eotaxin (CCL11). This study revealed that the majority of the markers decreased from pregnancy to postpartum, and only a few increased. Several of the top proteins that were higher in pregnancy than postpartum have anti-inflammatory and immune modulatory properties promoting pregnancy progress. These results clearly reflect the tremendous change in the immune system in the pregnancy to postpartum transition.

Place, publisher, year, edition, pages
NATURE PUBLISHING GROUP, 2019
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-378379 (URN)10.1038/s41598-018-38304-w (DOI)000458401500066 ()30755659 (PubMedID)
Funder
Swedish Research Council, VR:521-2013-2339Swedish Research Council, 523-2014-2342Marianne and Marcus Wallenberg Foundation
Available from: 2019-03-05 Created: 2019-03-05 Last updated: 2019-03-05Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4935-7532

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