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Publications (10 of 30) Show all publications
Karamanis, G., Frisell, T., Holmberg, M., Halldin, M., Sylvén, S., Skalkidou, A. & Papadopoulos, F. C. (2023). Incidence of Idiopathic Intracranial Hypertension in Individuals With Gonadotropin-Releasing Hormone Analogue Treatment for Gender Dysphoria in Sweden [Letter to the editor]. JAMA pediatrics, 177(7), 726-727
Open this publication in new window or tab >>Incidence of Idiopathic Intracranial Hypertension in Individuals With Gonadotropin-Releasing Hormone Analogue Treatment for Gender Dysphoria in Sweden
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2023 (English)In: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211, Vol. 177, no 7, p. 726-727Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
American Medical Association (AMA), 2023
National Category
Psychiatry Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-512286 (URN)10.1001/jamapediatrics.2023.0656 (DOI)000989546800005 ()37126330 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2021-01968Region Uppsala
Available from: 2023-09-24 Created: 2023-09-24 Last updated: 2023-09-26Bibliographically approved
Cato, K., Sylvén, S. M., Wahlström Eriksson, H. & Rubertsson, C. (2020). Breastfeeding as a balancing act: pregnant Swedish women’s voices on breastfeeding. International Breastfeeding Journal, 15, Article ID 16.
Open this publication in new window or tab >>Breastfeeding as a balancing act: pregnant Swedish women’s voices on breastfeeding
2020 (English)In: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 15, article id 16Article in journal (Refereed) Published
Abstract [en]

Background: Breastfeeding provides health benefits to both women and children. The rationale behind an individual woman's decision to breastfeed or not can depend on several factors, either independently or in combination. The aim of the current study was to explore attitudes towards breastfeeding among pregnant women in Sweden who intend to breastfeed.

Methods: Eleven mothers-to-be, one of whom had previous breastfeeding experience, participated in the study. The women were interviewed either by telephone or face-to-face during late pregnancy, with the aim of exploring their attitudes towards breastfeeding. A semi-structured interview-guide was used, and the transcripts of the interviews were analyzed using thematic analysis. The social ecological model of health is the theory-based framework underpinning this study. The model provides a comprehensive approach to understanding the factors that influence breastfeeding intention.

Results: When interviewed during pregnancy, women described breastfeeding as a balancing act between societal norms and personal desires. The women perceived a societal pressure to breastfeed, however it was accompanied by boundaries and mixed messages. This perceived pressure was balanced by their own knowledge of breastfeeding, in particular their knowledge of other women's experience of breastfeeding. When envisioning their future breastfeeding, the women made uncertain and preliminary plans, and negotiated the benefits and drawbacks of breastfeeding. There was a wish for individual breastfeeding support and information.

Conclusions: Pregnant Swedish women perceive their future breastfeeding as a balancing act between societal norms and personal desires. These findings suggest that while discussing breastfeeding during pregnancy, it could be of interest to collect information from pregnant women on their knowledge of breastfeeding and from where they have gained this knowledge, since stories from family and friends may make them question their own capacity to breastfeed. A thorough review of the woman's experiences and attitudes of breastfeeding is important in order to offer the best evidence-based breastfeeding support.

National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-348655 (URN)10.1186/s13006-020-00257-0 (DOI)000519017900001 ()32138725 (PubMedID)
Funder
Swedish Research Council
Available from: 2018-04-16 Created: 2018-04-16 Last updated: 2020-04-06Bibliographically approved
Sylvén, S. M., Gingnell, M., Ramirez, A. & Bodén, R. (2020). Transcranial magnetic intermittent theta-burst stimulation for depression in pregnancy - A case series [Letter to the editor]. Brain Stimulation, 13(6), 1665-1667
Open this publication in new window or tab >>Transcranial magnetic intermittent theta-burst stimulation for depression in pregnancy - A case series
2020 (English)In: Brain Stimulation, ISSN 1935-861X, E-ISSN 1876-4754, Vol. 13, no 6, p. 1665-1667Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC, 2020
National Category
Neurology Neurosciences
Identifiers
urn:nbn:se:uu:diva-434903 (URN)10.1016/j.brs.2020.09.013 (DOI)000597945200030 ()33002646 (PubMedID)
Funder
Swedish Research Council, 2016-02362
Available from: 2021-02-24 Created: 2021-02-24 Last updated: 2021-02-24Bibliographically 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
Axfors, C., Bränn, E., Henriksson, H. E., Hellgren, C., Kunovac Kallak, T., 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, 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.

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)000512882200216 ()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: 2023-08-28Bibliographically approved
Henriksson, H. E., White, R. A., Sylvén, S. M., Papadopoulos, F. & Skalkidou, A. (2018). Meteorological parameters and air pollen count in association with self-reported peripartum depressive symptoms. European psychiatry, 54, 10-18
Open this publication in new window or tab >>Meteorological parameters and air pollen count in association with self-reported peripartum depressive symptoms
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2018 (English)In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 54, p. 10-18Article in journal (Refereed) Published
Abstract [en]

Background: Meteorological parameters and air pollen count have been associated with affective disorders and suicide. Regarding peripartum depression, the literature is restricted and inconclusive.

Methods: This cross-sectional study included women (pregnant, n = 3843; postpartum, n = 3757) who participated in the BASIC (Biology, Affect, Stress, Imaging, and Cognition) study 2010-2015 and the UPPSAT (Uppsala-Athens) study (postpartum, n = 1565) in 2006-2007. Cases were defined according to presence of depressive symptoms during pregnancy (gestational week 32) and 6 weeks postpartum, using the Edinburgh Postnatal Depression Scale (EPDS). Exposure of sunshine, temperature, precipitation, snow coverage, and air pollen counts of durations of 1, 7, and 42 days prior to the outcome were studied for associations with depressive symptoms, using negative binomial regression.

Results: Prior to Bonferroni correction, the concentration of mugwort pollen, both one week and six weeks before the EPDS assessment at gestational week 32, was inversely associated with depressive symptoms in pregnancy, both before and after adjustment for season. No associations were found between the exposure to meteorological parameters and pollen and depressive symptoms, at the same day of depressive symptoms' assessment, the previous week, or the six weeks prior to assessment, either during pregnancy or postpartum after Bonferroni correction.

Conclusions: There was no evidence that neither short-term nor long-term exposure to meteorological parameters or air pollen counts were associated with self-reported peripartum depressive symptoms in Uppsala, Sweden.

Place, publisher, year, edition, pages
ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER, 2018
Keywords
Meteorological parameters, Pollen, Postpartum, Antenatal, Peripartum, Depressive symptoms
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-363217 (URN)10.1016/j.eurpsy.2018.06.010 (DOI)000445399800002 ()30031991 (PubMedID)
Funder
Swedish Research Council, 523-2014-2342Swedish Society of Medicine, SLS-250581Marianne and Marcus Wallenberg Foundation, MMW2011.0115Åke Wiberg FoundationStiftelsen Söderström - Königska sjukhemmet
Available from: 2018-10-15 Created: 2018-10-15 Last updated: 2019-04-17Bibliographically approved
Axfors, C., Sylvén, S., Ramklint, M. & Skalkidou, A. (2017). Adult attachment's unique contribution in the prediction of postpartum depressive symptoms, beyond personality traits. Journal of Affective Disorders, 222, 177-184
Open this publication in new window or tab >>Adult attachment's unique contribution in the prediction of postpartum depressive symptoms, beyond personality traits
2017 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 222, p. 177-184Article in journal (Refereed) Published
Abstract [en]

Background:

Personality traits such as neuroticism can help identify pregnant women at risk of postpartum depressive symptoms (PPDS). However, it is unclear whether attachment style could have an additional contribution to this risk elevation. This study aimed to examine the overlap of adult attachment insecurity and neuroticism/trait anxiety as PPDS predictors, taking into account baseline depressive symptoms.

Methods:

A Swedish population-based sample of pregnant women reported on adult attachment and either neuroticism (n = 1063) or trait anxiety (n = 555). Depressive symptoms were assessed at baseline, and at six weeks and six months postpartum. Correlations between attachment and neuroticism/trait anxiety were calculated. Generalized linear models of PPDS tested the effect of attachment anxiety and avoidance, adjusting for neuroticism/trait anxiety and baseline depression. Logistic regression models with combined high attachment anxiety and-neuroticism/trait anxiety visualized their value as risk factors beyond antenatal depression.

Results:

Attachment and neuroticism/trait anxiety were highly correlated (r = .55.77). Attachment anxiety exerted a partially independent effect on PPDS at six weeks (p < .05) and at six months (p < .05) adjusting for neuroticism. Among antenatally non-depressed, combined high attachment anxiety and high neuroticism or trait anxiety was predictive of PPDS at both assessment points. Limitations: Low acceptance rate, exclusive use of self-reports.

Conclusions:

Beyond personality, attachment anxiety had a small independent effect on the risk of PPDS. Combining items of adult attachment and neuroticism/trait anxiety could prove useful in antenatal screening for high risk of PPDS.

Keywords
Adult attachment, Neuroticism, Trait anxiety, Personality, Pregnancy, Postpartum depression
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-333735 (URN)10.1016/j.jad.2017.07.005 (DOI)000407657100027 ()28709025 (PubMedID)
Available from: 2017-11-20 Created: 2017-11-20 Last updated: 2018-10-24Bibliographically approved
Sylvén, S. M., Thomopoulos, T. P., Kollia, N., Jonsson, M. & Skalkidou, A. (2017). Correlates of postpartum depression in first time mothers without previous psychiatric contact. European psychiatry, 40, 4-12
Open this publication in new window or tab >>Correlates of postpartum depression in first time mothers without previous psychiatric contact
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2017 (English)In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 40, p. 4-12Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Postpartum depression (PPD) is a common disorder after childbirth. The strongest known predictors are a history of depression and/or a history of PPD. However, for a significant proportion of women, PPD constitutes their first depressive episode. This study aimed to gain further insight into the risk factors for PPD in first time mothers without previous psychiatric contact.

METHODS: Women delivering in Uppsala University Hospital, Sweden, from May 2006 to June 2007, were asked to participate and filled out questionnaires five days and six weeks postpartum, containing inter alia the Edinburgh Postnatal Depression Scale (EPDS). Univariate logistic regression models, as well as a path analysis, were performed to unveil the complex interplay between the study variables.

RESULTS: Of the 653 participating primiparas, 10.3% and 6.4% reported depressive symptoms (EPDS≥12 points) five days and six weeks postpartum, respectively. In the path analysis, a positive association between anxiety proneness and depressive symptoms at five days and six weeks postpartum was identified. For depressive symptoms six weeks after delivery, additional risk factors were detected, namely depressive symptoms five days postpartum and subjective experience of problems with the baby. Caesarean section and assisted vaginal delivery were associated with fewer depressive symptoms at 6 six weeks postpartum.

CONCLUSIONS: Identification of anxiety proneness, delivery mode and problems with the baby as risk factors for self-reported depressive symptoms postpartum in this group of primiparas can be important in helping health care professionals identify women at increased risk of affective disorders in the perinatal period, and provide a base for early intervention.

Keywords
Depression, Path analysis, Peripartum, Postpartum, Primipara
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-319199 (URN)10.1016/j.eurpsy.2016.07.003 (DOI)000396967600002 ()27837672 (PubMedID)
Funder
Marianne and Marcus Wallenberg FoundationSwedish Research CouncilThe Swedish Medical AssociationStiftelsen Söderström - Königska sjukhemmet
Available from: 2017-03-31 Created: 2017-03-31 Last updated: 2018-09-17Bibliographically approved
Axfors, C., Sylvén, S., Skalkidou, A. & Ramklint, M. (2017). Psychometric properties of the attachment style questionnaire in Swedish pregnant women: short and full versions. Journal of Reproductive and Infant Psychology, 35(5), 450-461
Open this publication in new window or tab >>Psychometric properties of the attachment style questionnaire in Swedish pregnant women: short and full versions
2017 (English)In: Journal of Reproductive and Infant Psychology, ISSN 0264-6838, E-ISSN 1469-672X, Vol. 35, no 5, p. 450-461Article in journal (Refereed) Published
Abstract [en]

Objectives: (i) To evaluate the reliability and factor structure of the Attachment Style Questionnaire – Short Form (ASQ-SF) for use in pregnant women and (ii) to compare the reliability and factor structure of the short- and full version-ASQ among pregnant women. Background: Adult attachment insecurity is currently included as a major risk factor in studies of perinatal health. None of the self-report measures with a Swedish translation have been psychometrically evaluated in a pregnant cohort.

Methods: A population-based cohort of 1631 pregnant women answered the ASQ in late pregnancy. Internal consistency (item- subscale correlations, Cronbach’s α, and α if item deleted) was evaluated for the seven available subscales. Con rmatory factor analysis (CFA) was run to examine the factor structure of the short form compared with the full-version. Test–retest correlations were assessed in a subgroup (n = 48).

Results: All mean item-subscale correlations for the ASQ-SF were > 0.30. Cronbach’s α’s for ASQ-SF dimensions were as follows: Avoidance (0.87); Anxiety (0.89); Discomfort with Closeness (0.85); Relationships as Secondary (0.54); Con dence (0.83); Need for Approval (0.76); and Preoccupation with Relationships (0.77). No item removal substantively increased subscale α’s. The CFA demonstrated better model t for the ASQ-SF than for the full-version ASQ, while other reliability measures were similar. Test–retest correlations ranged from 0.65 to 0.84.

Conclusion: The ASQ-SF showed similar psychometric properties in pregnant women as in the general population and had good reliability, but the optimal factor structure needs to be studied further. Results support the usage of the ASQ-SF in pregnant cohorts. 

Place, publisher, year, edition, pages
Routledge, 2017
Keywords
adult attachment, attachment style questionnaire, reliability, pregnancy
National Category
Clinical Medicine
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-342268 (URN)10.1080/02646838.2017.1342786 (DOI)000416753300003 ()
Funder
Swedish Research Council, 521-2013-2339
Available from: 2018-02-19 Created: 2018-02-19 Last updated: 2018-10-24Bibliographically approved
Cato, K., Sylvén, S. M., Lindbäck, J., Skalkidou, A. & Rubertsson, C. (2017). Risk factors for exclusive breastfeeding lasting less than two months-Identifying women in need of targeted breastfeeding support. PLOS ONE, 12(6), Article ID e0179402.
Open this publication in new window or tab >>Risk factors for exclusive breastfeeding lasting less than two months-Identifying women in need of targeted breastfeeding support
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2017 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 12, no 6, article id e0179402Article in journal (Refereed) Published
Abstract [en]

Background: Breastfeeding rates in Sweden are declining, and it is important to identify women at risk for early cessation of exclusive breastfeeding.

Objective: The aim of this study was to investigate factors associated with exclusive breastfeeding lasting less than two months postpartum.

Methods: A population-based longitudinal study was conducted at Uppsala University Hospital, Sweden. Six hundred and seventy-nine women were included in this sub-study. Questionnaires were sent at five days, six weeks and six months postpartum, including questions on breastfeeding initiation and duration as well as several other background variables. The main outcome measure was exclusive breastfeeding lasting less than two months postpartum. Multivariable logistic regression analysis was used in order to calculate adjusted Odds Ratios (AOR) and 95% Confidence Intervals (95% CI).

Results: Seventy-seven percent of the women reported exclusive breastfeeding at two months postpartum. The following variables in the multivariate regression analysis were independently associated with exclusive breastfeeding lasting less than two months postpartum: being a first time mother (AOR 2.15, 95% CI 1.32 +/- 3.49), reporting emotional distress during pregnancy (AOR 2.21, 95% CI 1.35 +/- 3.62) and giving birth by cesarean section (AOR 2.63, 95% CI 1.34 +/- 5.17).

Conclusions: Factors associated with shorter exclusive breastfeeding duration were determined. Identification of women experiencing emotional distress during pregnancy, as well as scrutiny of caregiving routines on cesarean section need to be addressed, in order to give individual targeted breastfeeding support and promote longer breastfeeding duration.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2017
National Category
Health Sciences
Identifiers
urn:nbn:se:uu:diva-329674 (URN)10.1371/journal.pone.0179402 (DOI)000403280900048 ()28614419 (PubMedID)
Funder
Swedish Research Council, 523-2014-2342Marianne and Marcus Wallenberg Foundation, MMW2011.0115Åke Wiberg Foundation
Available from: 2017-09-19 Created: 2017-09-19 Last updated: 2021-06-14Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3142-5111

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