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Åkerud, Helena
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Publications (10 of 79) Show all publications
Sterpu, I., Anfelter, P., Wray, S., Kaihola, H., Åkerud, H. & Wiberg-Itzel, E. (2019). The association of second trimester biomarkers in amniotic fluid and fetal outcome. The Journal of Maternal-Fetal & Neonatal Medicine, 32(21), 3627-3632
Open this publication in new window or tab >>The association of second trimester biomarkers in amniotic fluid and fetal outcome
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2019 (English)In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, E-ISSN 1476-4954, Vol. 32, no 21, p. 3627-3632Article in journal (Refereed) Published
Abstract [en]

Objective: To identify the level of amniotic fluid lactate (AFL), placental growth factor (PLGF), and vascular endothelial growth factor (VEGF) at second trimester amniocentesis, and to compare levels in normal pregnancies with pregnancies ending in a miscarriage, an intrauterine growth restricted fetus (IUGR) or decreased fetal movements.

Study design: A prospective cohort study. Amniotic fluid was consecutively collected at amniocentesis in 106 pregnancies. Fetal wellbeing at delivery was evaluated from medical files and compared with the levels of AFL, VEGF, and PLGF at the time of amniocentesis.

Results: The median level of AFL was 6.9 mmol/l, VEGF 0.088 pg/ml, and PLGF 0.208 pg/ml. The median levels of AFL in pregnancies ended in miscarriage were significantly higher (10.7 mmol/l) compared to those with a live new-born (6.9 mmol/L, p = .02). The levels of VEGF (p = .2) and PLGF (p = .7) were not affected. In pregnancies with an IUGR, the median level of AFL was higher compared to those with normal fetal growth (p = .003). No differences VEGF (p = .5), but significant lower PLGF were found in IUGR pregnancies (p = .03).

Conclusions: Pregnancies ending in a miscarriage or with IUGR had significantly higher median values of AFL but lower values of PLGF in the amniotic fluid at the time of second trimester amniocentesis compared to normal pregnancies.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2019
Keywords
Biomarkers, amniocentesis, AFL, PLGF, VEGF
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-392116 (URN)10.1080/14767058.2018.1469127 (DOI)000478069900020 ()29685073 (PubMedID)
Available from: 2019-09-06 Created: 2019-09-06 Last updated: 2019-09-06Bibliographically approved
Wiberg-Itzel, E., Wray, S. & Åkerud, H. (2018). A randomized controlled trial of a new treatment for labor dystocia. The Journal of Maternal-Fetal & Neonatal Medicine, 31(17), 2237-2244
Open this publication in new window or tab >>A randomized controlled trial of a new treatment for labor dystocia
2018 (English)In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, E-ISSN 1476-4954, Vol. 31, no 17, p. 2237-2244Article in journal (Refereed) Published
Abstract [en]

Objective: Labor dystocia is an intransigent, high-profile issue in obstetric care. Amniotic fluid lactate (AFL) reflects the uterine metabolic status. High levels associate with subsequent need for operative intervention due to dystocia. In sports medicine, it is known that lactic acid can affect muscular performance and can be decreased by bicarbonate given orally before physical activity.

Material and methods: Two hundred dystocic deliveries were included. At the confirmation of dystocia, the AFL-level was analyzed. Deliveries were randomized to an intake of bicarbonate or not. In the non-bicarbonate-group, stimulation with oxytocin was started immediately. In the bicarbonate-group, bicarbonate was given; and oxytocin was started 1hour after the intake. New sampling of AF was performed after 1hour in both groups. Outcome measured: if an oral intake of bicarbonate changes the AFL levels and enhances delivery outcome in dystocic deliveries.

Results: Bicarbonate decreases the AFL levels (p<.001). The spontaneous vaginal delivery rate after treatment with bicarbonate was increased (p=.007), without affecting the fetal outcome.

Conclusions: An increase of spontaneous vaginal deliveries resulted from bicarbonate ingestion by dystocic women. A decreased level of AFL-level was shown. This simple, low cost treatment has the potential to improve maternal morbidity and satisfaction worldwide.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2018
Keywords
AFL, bicarbonate, caesarean, dystocia, labor
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-356816 (URN)10.1080/14767058.2017.1339268 (DOI)000432700800002 ()28587493 (PubMedID)
Available from: 2018-08-16 Created: 2018-08-16 Last updated: 2018-08-16Bibliographically approved
Sterpu, I. S., Åkerud, H., Kaihola, H. & Itzel, E. W. (2018). Angiogenic factors as biomarkers for fetal wellbeing during delivery. Paper presented at 38th Annual Meeting and Pregnancy Meeting of the Society-for-Maternal-Fetal-Medicine, JAN 29-FEB 03, 2018, Dallas, TX. American Journal of Obstetrics and Gynecology, 218(1: Supplement), S186-S186
Open this publication in new window or tab >>Angiogenic factors as biomarkers for fetal wellbeing during delivery
2018 (English)In: American Journal of Obstetrics and Gynecology, ISSN 0002-9378, E-ISSN 1097-6868, Vol. 218, no 1: Supplement, p. S186-S186Article in journal, Meeting abstract (Other academic) Published
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-350205 (URN)10.1016/j.ajog.2017.10.224 (DOI)000422946900296 ()
Conference
38th Annual Meeting and Pregnancy Meeting of the Society-for-Maternal-Fetal-Medicine, JAN 29-FEB 03, 2018, Dallas, TX
Note

Meeting Abstract: 295

Available from: 2018-05-08 Created: 2018-05-08 Last updated: 2018-05-08Bibliographically approved
Edvinsson, Å., Olivier, J., Hellgren, C., Kallak, T. K., Åkerud, H., Skalkidou, A., . . . Sundström Poromaa, I. (2018). Antenatal Depression and Placental Function: A Protein Validated Gene Expression Study. Paper presented at Meeting of the International-Federation-of-Placenta-Associations (IFPA), SEP 21-24, 2018, Tokyo, JAPAN. Placenta, 69, E62-E62
Open this publication in new window or tab >>Antenatal Depression and Placental Function: A Protein Validated Gene Expression Study
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2018 (English)In: Placenta, ISSN 0143-4004, E-ISSN 1532-3102, Vol. 69, p. E62-E62Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
W B SAUNDERS CO LTD, 2018
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-367143 (URN)000444236500217 ()
Conference
Meeting of the International-Federation-of-Placenta-Associations (IFPA), SEP 21-24, 2018, Tokyo, JAPAN
Available from: 2018-11-29 Created: 2018-11-29 Last updated: 2018-11-29Bibliographically approved
Nelander, M., Hannsberger, D., Sundström Poromaa, I., Bergman, L., Weis, J., Åkerud, H., . . . Wikström, A.-K. (2018). Assessment of cerebral perfusion and edema in preeclampsia with intravoxel incoherent motion MRI.. Acta Obstetricia et Gynecologica Scandinavica, 97(10), 1212-1218
Open this publication in new window or tab >>Assessment of cerebral perfusion and edema in preeclampsia with intravoxel incoherent motion MRI.
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2018 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 97, no 10, p. 1212-1218Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Cerebral complications are the main reasons for morbidity and mortality in preeclampsia and eclampsia. As yet, we do not know whether the pathophysiology entails hypo- or hyperperfusion of the brain, or how and when edema emerges, due to the difficulty of examining the cerebral circulation.

MATERIAL AND METHODS: We have used a non-invasive diffusion weighted-magnetic resonance imaging technique, intravoxel incoherent motion, to study cerebral perfusion on the capillary level and cerebral edema in women with preeclampsia (n = 30), normal pregnancy (n = 32), and non-pregnant women (n = 16). Estimates of cerebral blood volume, blood flow, and edema were measured in 5 different regions. These points were chosen to represent blood supply areas of both the carotid and vertebrobasilar arteries, and to include both white and gray matter.

RESULTS: Except for the caudate nucleus, we did not detect any differences in cerebral perfusion measures on a group level. In the caudate nucleus, we found lower cerebral blood volume and lower blood flow in preeclampsia than in either normal pregnancy (P = .01 and P = .03, respectively) or non-pregnant women (both P = .02). No differences in edema were detected between study groups.

CONCLUSION: The cerebral perfusion measures were comparable between the study groups, except for a portion of the basal ganglia where hypoperfusion was detected in preeclampsia but not in normal pregnancy or non-pregnant women.

Keywords
cerebral circulation, eclampsia, edema, intravoxel incoherent motion, magnetic resonance imaging, perfusion, preeclampsia
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-357423 (URN)10.1111/aogs.13383 (DOI)000444070900010 ()29786833 (PubMedID)
Funder
Swedish Research Council, 2014-3561
Available from: 2018-08-16 Created: 2018-08-16 Last updated: 2018-11-14Bibliographically approved
Bergman, L., Zetterberg, H., Kaihola, H., Hagberg, H., Blennow, K. & Åkerud, H. (2018). Blood-based cerebral biomarkers in preeclampsia: Plasma concentrations of NfL, tau, S100B and NSE during pregnancy in women who later develop preeclampsia - A nested case control study. PLoS ONE, 13(5), Article ID e0196025.
Open this publication in new window or tab >>Blood-based cerebral biomarkers in preeclampsia: Plasma concentrations of NfL, tau, S100B and NSE during pregnancy in women who later develop preeclampsia - A nested case control study
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2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 5, article id e0196025Article in journal (Refereed) Published
Abstract [en]

Objective To evaluate if concentrations of the neuronal proteins neurofilament light chain and tau are changed in women developing preeclampsia and to evaluate the ability of a combination of neurofilament light chain, tau, S100B and neuron specific enolase in identifying neurologic impairment before diagnosis of preeclampsia. Methods A nested case-control study within a longitudinal study cohort was performed. 469 healthy pregnant women were enrolled between 2004-2007 and plasma samples were collected at gestational weeks 10, 25, 28, 33 and 37. Plasma concentrations of tau and neurofilament light chain were analyzed in 16 women who eventually developed preeclampsia and 36 controls throughout pregnancy with single molecule array (Simoa) method and compared within and between groups. S100B and NSE had been analyzed previously in the same study population. A statistical model with receiving characteristic operation curve was constructed with the four biomarkers combined. Results Plasma concentrations of neurofilament light chain were significantly increased in women who developed preeclampsia in gestational week 33 (11.85 ng/L, IQR 7.48-39.93 vs 6.80 ng/L, IQR 5.65-11.40) and 37 (22.15 ng/L, IQR 10.93-35.30 vs 8.40 ng/L, IQR 6.40-14.30) and for tau in gestational week 37 (4.33 ng/L, IQR 3.97-12.83 vs 3.77 ng/L, IQR 1.91-5.25) in contrast to healthy controls. A combined model for preeclampsia with tau, neurofilament light chain, S100B and neuron specific enolase in gestational week 25 displayed an area under the curve of 0.77, in week 28 it was 0.75, in week 33 it was 0.89 and in week 37 it was 0.83. Median week for diagnosis of preeclampsia was at 38 weeks of gestation. Conclusion Concentrations of both tau and neurofilament light chain are increased in the end of pregnancy in women developing preeclampsia in contrast to healthy pregnancies. Cerebral biomarkers might reflect cerebral involvement before onset of disease.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2018
National Category
Obstetrics, Gynecology and Reproductive Medicine Neurosciences
Identifiers
urn:nbn:se:uu:diva-358098 (URN)10.1371/journal.pone.0196025 (DOI)000431281900042 ()29719006 (PubMedID)
Funder
EU, European Research CouncilKnut and Alice Wallenberg FoundationSwedish Research Council, D 2013-2546Swedish Research Council, D0277902Swedish Research Council, D0277901Torsten Söderbergs stiftelse
Available from: 2018-08-24 Created: 2018-08-24 Last updated: 2018-08-24Bibliographically approved
Skírnisdottir, I., Åkerud, H. & Seidal, T. (2018). Clinical significance of growth factor receptor EGFR and angiogenesis regulator VEGF‑R2 in patients with ovarian cancer at FIGO stages I-II.. International Journal of Oncology, 53(4), 1633-1642
Open this publication in new window or tab >>Clinical significance of growth factor receptor EGFR and angiogenesis regulator VEGF‑R2 in patients with ovarian cancer at FIGO stages I-II.
2018 (English)In: International Journal of Oncology, ISSN 1019-6439, Vol. 53, no 4, p. 1633-1642Article in journal (Refereed) Published
Abstract [en]

The aim of the present retrospective cohort study was to investigate the prognostic effect of epidermal growth factor receptor (EGFR) and the angiogenesis regulator vascular endothelial growth factor receptor 2 (VEGF‑R2) on disease-free survival (DFS) rate and recurrent disease, and their association with clinicopathological characteristics in 131 patients with International Federation of Gynecology and Obstetrics (FIGO) stages I-II epithelial ovarian cancer. The techniques of tissue microar-rays and immunohistochemistry were used for the positive detection of the markers. The frequency of positive staining in tumors for EGFR was 24% and for VEGF‑R2 was 77%. Across the cohort, there was a total of 34/131 recurrences (26%) and the 5‑year DFS rate was 68%. In a multivariate logistic regression analysis with recurrent disease as the endpoint, FIGO stage (OR=9.7), type (I/II) of tumor (OR=3.0) and VEGF‑R2 status (OR=0.2) were all found to be independent predictive factors in the cohort of patients (n=131). For patients with non‑serous tumors (n=78), the FIGO stage (OR=76), type (I/II) of tumor (OR=44), EGFR status (OR=0.05) and VEGF‑R2 status (OR=0.008) were all significant and independent predictive factors. On comparing the four subgroups, in terms of concomitant EGFR and VEGF‑R2 status, in a survival analysis, the subgroup of patients (n=21) with concomitant positive expression of EGFR and VEGF‑R2 had a 5‑year DFS rate of 100%. Therefore, the prognostic effect of EGFR and VEGF‑R2 for recurrent disease and survival rates was confirmed by the above findings. Certain results in the present study were not in line with results from previous studies on the prognostic effect of EGFR and VEGF‑R2. An increasing number of preclinical and clinical observations have shown that the process of angiogenesis remains to be fully elucidated. Therefore, one of the challenges for future ovarian cancer investigations is to identify which biomarkers may be used as predictive and prognostic markers.

National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-359900 (URN)10.3892/ijo.2018.4511 (DOI)000442971100018 ()30066848 (PubMedID)
Available from: 2018-09-06 Created: 2018-09-06 Last updated: 2018-10-03Bibliographically approved
Lindgren, K. E., Yaldir, F. G., Hreinsson, J., Holte, J., Kårehed, K., Sundström Poromaa, I., . . . Åkerud, H. (2018). Differences in secretome in culture media when comparing blastocysts and arrested embryos using multiplex proximity assay. Upsala Journal of Medical Sciences, 123(3), 143-152
Open this publication in new window or tab >>Differences in secretome in culture media when comparing blastocysts and arrested embryos using multiplex proximity assay
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2018 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 123, no 3, p. 143-152Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of this study was to assess different patterns of the human embryo secretome analysed as protein levels in culture media. Furthermore, analyses to correlate protein levels with quality and timing to development of human embryos were performed.

Material and methods: Human day-2 cryopreserved embryos were cultured for four days in an EmbryoScope((R)) with a time-lapse camera, and embryo quality was evaluated retrospectively. After culture, the media were collected and relative levels of secreted proteins were analysed using Proseek Multiplex Assays. Protein levels were evaluated in relation to timing to development and the ability to form a blastocyst.

Results: Specific patterns of timing of development of blastocysts were found, where a difference in time to start of cavitation was found between high- and low-quality blastocysts. There appeared to be a correlation between specific protein patterns and successful formation of morulae and blastocysts. Embryos developing into blastocysts had higher levels of EMMPRIN than arrested embryos, and levels of caspase-3 were lower in high- versus low-quality blastocysts. Also, higher levels of VEGF-A, IL-6, and EMMPRIN correlated with shorter times to morula formation.

Conclusions: The secretome and timing to development differ in embryos forming blastocysts and those that become arrested, and in high- versus low-quality blastocysts. The levels of certain proteins also correlate to specific times to development.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2018
Keywords
Blastocyst, caspase-3, extracellular matrix metalloproteinase inducer, interleukin-6, prediction, secretome, time-lapse, vascular endothelial growth factor A
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-368773 (URN)10.1080/03009734.2018.1490830 (DOI)000446977000002 ()30282508 (PubMedID)
Funder
Swedish Research Council, FF-2017-477Swedish Society of MedicineStiftelsen Olle Engkvist Byggmästare
Available from: 2018-12-10 Created: 2018-12-10 Last updated: 2018-12-10Bibliographically approved
Elenis, E., Skalkidou, A., Skoog Svanberg, A., Sydsjö, G., Stavreus-Evers, A. & Åkerud, H. (2018). HRG C633T polymorphism and risk of gestational hypertensive disorders: a pilot study. BMC Medical Genetics, 19, Article ID 44.
Open this publication in new window or tab >>HRG C633T polymorphism and risk of gestational hypertensive disorders: a pilot study
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2018 (English)In: BMC Medical Genetics, ISSN 1471-2350, E-ISSN 1471-2350, Vol. 19, article id 44Article in journal (Refereed) Published
Abstract [en]

Background: Preeclampsia and gestational hypertensive disorders are thought to occur due to endothelial cell dysfunction and abnormal placentation, triggered by angiogenesis-related factors yet undetermined. The aim of this study was to investigate whether a genetic polymorphism (SNP) of Histidine-rich glycoprotein (HRG), HRG C633T SNP, is associated with gestational hypertensive disorders.

Methods: It was performed a nested case-control study from the BASIC Cohort of Uppsala University Hospital comprising 92 women diagnosed with gestational hypertensive disorders without other comorbidities and 200 women with full term uncomplicated pregnancies, all genotyped regarding HRG C633T SNP.

Results: The genetic analysis of the study sample showed that C/C genotype was more prevalent among controls. The presence of the T-allele showed a tendency towards an increased risk of gestational hypertensive disorders. After clustering the study participants based on their genotype, it was observed that the odds for gestational hypertensive disorders among heterozygous C/T or homozygous T/T carriers were higher compared to homozygous C/C carriers [OR 1.72, 95% CI (1.04-2.84)]. The association remained significant even after adjustment for maternal age, BMI and parity.

Conclusions: The HRG C633T genotype seems to be associated with gestational hypertensive disorders, and as part of a greater algorithm, might contribute in the future to the prediction of the individual susceptibility to the condition.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2018
Keywords
Angiogenesis, Gestational hypertensive disorders, HRG, HRG C633T SNP, Preeclampsia
National Category
Obstetrics, Gynecology and Reproductive Medicine Medical Genetics
Identifiers
urn:nbn:se:uu:diva-351434 (URN)10.1186/s12881-018-0550-8 (DOI)000427996000001 ()29540166 (PubMedID)
Funder
Swedish Research Council, D0277902Swedish Research Council, D0277901
Available from: 2018-05-31 Created: 2018-05-31 Last updated: 2018-05-31Bibliographically approved
Husseini-Akram, F., Haroun, S., Altmae, S., Skjoldebrand-Sparre, L., Åkerud, H., Sundström Poromaa, I., . . . Stavreus-Evers, A. (2018). Hyaluronan-binding protein 2 (HABP2) gene variation in women with recurrent miscarriage. BMC Women's Health, 18, Article ID 143.
Open this publication in new window or tab >>Hyaluronan-binding protein 2 (HABP2) gene variation in women with recurrent miscarriage
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2018 (English)In: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 18, article id 143Article in journal (Refereed) Published
Abstract [en]

Background:

Idiopathic recurrent miscarriage, defined as three or more consecutive miscarriages, is a distressing early pregnancy complication. Although, the etiology of recurrent miscarriage is still unknown, an aberrant regulation of the endometrial receptivity marker hyaluronan-binding protein 2 (HABP2) has been suggested. The objective of the present study was to investigate the effect of genetic variations of HABP2 in women with idiopathic recurrent miscarriage compared to fertile women.

Methods:

This study was designed as a case-control study. In total, 165 women who had three or more consecutive miscarriages and 289 fertile women were included in the study. Polymorphisms in the HABP2 gene were analyzed using TaqMan SNP Genotyping Assays. Three polymorphisms in the HABP2 gene, rs1157916, rs2240879 and rs7080536 (Marburg I) were studied.

Results:

Polymorphism in HABP2 showed no significant difference in women with recurrent miscarriage compared to fertile women, except for rs1157916 minor A allele that was more prevalent among RM patients (p = 0.058). Significantly higher live birth rate was observed among women with three to four miscarriages compared to those with more miscarriages (p = 0.001).

Conclusions:

Variations in the HABP2 gene did not seem to be involved in the etiology of recurrent miscarriage, while, the number of previous miscarriages had an impact on the live birth rate.

Keywords
Genotype, Hyaluronan-binding protein2 (HABP2), Recurrent miscarriage
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-379249 (URN)10.1186/s12905-018-0618-9 (DOI)000460040400001 ()30143058 (PubMedID)
Available from: 2019-03-15 Created: 2019-03-15 Last updated: 2019-03-15Bibliographically approved
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