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Langen I, Langesæter E, Gunnes N, Almaas VM, Haugen G, Estensen ME, Sørbye IK. Hypertensive disorders of pregnancy among women with cardiovascular disease in Norway: A historical cohort study. Acta Obstet Gynecol Scand 2024. [PMID: 38597240 DOI: 10.1111/aogs.14841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Women with cardiovascular disease may be at increased risk of hypertensive disorders of pregnancy (HDP). We aimed to: (1) Investigate the occurrence of HDP in a cohort of pregnant women with cardiovascular disease and compare it with the occurrence in the general population. (2) Assess the association between maternal cardiovascular risk and risk of HDP. MATERIAL AND METHODS We reviewed clinical data on a cohort of 901 pregnancies among 708 women with cardiovascular disease who were followed at the National Unit for Pregnancy and Heart Disease and gave birth at Oslo University Hospital between 2003 and 2018. The exposure under study was maternal cardiovascular risk, classified as low, moderate, or high based on a modified classification by the World Health Organization. The main outcome of interest was HDP, which included pre-eclampsia and gestational hypertension. The proportion of HDP cases in the general population in the same period was extracted from the Medical Birth Registry of Norway. We used logistic regression to estimate crude and adjusted odds ratios (OR) of HDP, with associated 95% confidence intervals (CIs), for women with moderate- and high cardiovascular risk compared to women with low risk. RESULTS The occurrence of HDP in the study cohort was 12.1% (95% CI: 10.0%-14.4%) and varied between 8.7% (95% CI: 6.5%-11.3%) in the low-risk group, 15.7% (95% CI: 11.1%-21.4%) in the moderate-risk group, and 22.2% (95% CI: 15.1%-30.8%) in the high-risk group. By contrast, the nationwide occurrence of HDP was 5.1% (95% CI: 5.1%-5.2%). In the study cohort, the proportions of pregnancies with gestational hypertension and pre-eclampsia were similar (6.3% and 5.8%, respectively). Compared to pregnancies with low cardiovascular risk, the adjusted OR of HDP was 2.04 (95% CI: 1.21-3.44) in the moderate-risk group and 2.99 (95% CI: 1.73-5.18) in the high-risk group. CONCLUSIONS The occurrence of hypertensive disease of pregnancy in the study cohort was more than doubled compared to the general population in Norway. The risk of HDP increased with maternal cardiovascular risk group. We recommend taking into account maternal cardiovascular risk group when assessing risk and prophylaxis of HDP.
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Affiliation(s)
- Ingrid Langen
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Eldrid Langesæter
- Department of Anesthesia and Intensive Care Medicine, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Nina Gunnes
- Norwegian Research Centre for Women's Health, Oslo University Hospital, Oslo, Norway
| | - Vibeke Marie Almaas
- Department of Cardiology, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Fetal Medicine, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - Mette-Elise Estensen
- Department of Cardiology, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway
| | - Ingvil Krarup Sørbye
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Henriksen T, Sajjad MU, Haugen G, Michelsen TM. Placental energy metabolism: Evidence for a placental-maternal lactate-ketone trade in the human. Placenta 2024; 148:31-37. [PMID: 38350223 DOI: 10.1016/j.placenta.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 02/15/2024]
Abstract
INTRODUCTION Glucose from placenta is the predominant energy source for the fetus. Individual placentas exhibit a range of glucose handling from apparent net production to high consumption, presumably reflecting an ability of placenta to secure both own and fetal energy needs. A dependency of placenta on glucose as the main energy source could impede fetal supply. Placenta seems to release lactate to maternal side implying loss of energy. Whether placenta takes up ketones is unclear. Our main hypothesis was that the human placenta can release lactate to the maternal side but take up maternal ketones. METHODS An in vivo study of term uncomplicated pregnancies including 56 women delivered by cesarean section. We measured uterine and umbilical blood flow by Doppler ultrasonography, combined with blood sampling from maternal radial artery, uterine vein, umbilical artery and vein. Lactate and ketones were determined by quantitative nuclear magnetic resonance. RESULTS Placenta released lactate to the maternal side (median -36.65 μmol/min. Q1, Q3: 78.53, 13.29), p < 0.001), but not to the fetal side. A net uptake of maternal ketones was found (median (Q1, Q3): 59.12 (30.64, 131.46) μmol acetate equivalents/min, p < 0.001) which largely was metabolized by the uteroplacenta. The uptake of ketones was comparable in energy to the loss of lactate. DISCUSSION Placenta may release lactate to the maternal side. The energy lost by lactate may be compensated by uptake of maternal ketones. This lactate-ketone trade could benefit both placenta and the fetus by providing lactate for maternal gluconeogenesis and ketones for uteroplacental oxidative energy production.
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Affiliation(s)
- Tore Henriksen
- Department of Obstetrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Muhammad U Sajjad
- Department of Obstetrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Fetal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Trond M Michelsen
- Department of Obstetrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
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Hilde K, Gudmundsdóttir HK, Stensby Bains KE, Färdig M, Lødrup Carlsen KC, Jonassen CM, Kreyberg I, Nordlund B, Rehbinder EM, Paasche Roland MC, Skjerven HO, Staff AC, Vettukattil R, Haugen G. Fetal pulmonary artery Doppler blood flow velocity measures and early infant lung function. A prospective cohort study. J Matern Fetal Neonatal Med 2023; 36:2213796. [PMID: 37197978 DOI: 10.1080/14767058.2023.2213796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/01/2023] [Accepted: 05/09/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Reduced lung function at birth has evident antenatal origins and is associated with an increased risk of wheezing and asthma later in life. Little is known about whether blood flow in the fetal pulmonary artery, may impact postnatal lung function. OBJECTIVE Our primary aim was to investigate the potential associations between fetal Doppler blood flow velocity measures in the fetal branch pulmonary artery, and infant lung function by tidal flow-volume (TFV) loops at three months of age in a low-risk population. Our secondary aim was to explore the association between Doppler blood flow velocity measures in the umbilical and middle cerebral arteries, and the same lung function measures. METHODS In 256 non-selected pregnancies from the birth cohort study Preventing Atopic Dermatitis and ALLergies in Children (PreventADALL) we performed fetal ultrasound examination with Doppler blood flow velocity measurements at 30 gestational weeks (GW). We recorded the pulsatility index, peak systolic velocity, time-averaged maximum velocity, acceleration time/ejection time ratio, and time velocity integral primarily in the proximal pulmonary artery close to the pulmonary bifurcation. The pulsatility index was measured in the umbilical and middle cerebral arteries and the peak systolic velocity in the middle cerebral artery. The cerebro-placental ratio (ratio between pulsatility index in the middle cerebral and umbilical arteries) was calculated. Infant lung function was assessed using TFV loops in awake, calmly breathing three months old infants. The outcome was the time to peak tidal expiratory flow to expiratory time ratio (tPTEF/tE), tPTEF/tE <25th percentile, and tidal volume per kg body weight (VT/kg). Potential associations between fetal Doppler blood flow velocity measures and infant lung function were assessed using linear and logistic regressions. RESULTS The infants were born at median (min - max) 40.3 (35.6 - 42.4) GW, with a mean (SD) birth weight of 3.52 (0.46) kg, and 49.4% were females. The mean (SD) tPTEF/tE was 0.39 (0.1) and the 25th percentile was 0.33. Neither univariable nor multivariable regression models revealed any associations between fetal pulmonary blood flow velocity measures and tPTEF/tE, tPTEF/tE <25th percentile, or VT/kg at three months of age. Similarly, we did not observe associations between Doppler blood flow velocity measures in the umbilical and middle cerebral arteries and infant lung function measures. CONCLUSION In a cohort of 256 infants from the general population, fetal third-trimester Doppler blood flow velocity measures in the branch pulmonary, umbilical, and middle cerebral arteries were not associated with infant lung function measures at three months of age.
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Affiliation(s)
- Katarina Hilde
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Hrefna Katrín Gudmundsdóttir
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karen Eline Stensby Bains
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Martin Färdig
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Karin C Lødrup Carlsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Christine M Jonassen
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Ina Kreyberg
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Eva Maria Rehbinder
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Dermatology and Vaenerology, Oslo University Hospital, Oslo, Norway
| | | | - Håvard O Skjerven
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
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Sajjad MU, Henriksen T, Roland MCP, Haugen G, Michelsen TM. Maternal body mass index, birth weight, and placental glucose metabolism: Evidence for a role of placental hexokinase. Am J Obstet Gynecol 2023:S0002-9378(23)00798-6. [PMID: 37925123 DOI: 10.1016/j.ajog.2023.10.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND The principal fetal energy source is glucose provided by placental transfer of maternal glucose. However, the placenta's glucose consumption exhibits considerable variation. Hexokinase is the first and one of the rate-limiting enzymes of glycolysis that phosphorylates glucose to glucose 6-phosphate. The role of placental hexokinase activity in human placental glucose metabolism is unknown. OBJECTIVES To test the hypothesis that placental hexokinase activity is related to maternal body mass index, placental glucose uptake and consumption, and birth weight. STUDY DESIGN Sixty-seven healthy pregnant participants at term were included in this study at Oslo University Hospital, Norway. Placental hexokinase activity was measured by using a colorimetric assay. The mass of glucose taken up by the uteroplacental unit and the fetus was obtained by measuring arterio-venous glucose differences combined with Doppler assessment of uterine and umbilical blood flow. Blood samples were obtained from the maternal radial artery, uterine vein, and umbilical artery and vein. The uteroplacental glucose consumption constituted the difference between uteroplacental and fetal glucose uptake. Spearman's rank correlation was performed for statistical analyses to study the correlation of placental hexokinase activity (mU/mg protein) with prepregnancy body mass index, maternal glucose and insulin, birth weight, uteroplacental glucose uptake and consumption, and fetal glucose uptake (μmol/min). Partial rank correlation analysis was performed when controlling for hours of fasting or placental weight. RESULTS Hexokinase activity was detectable in all placental tissue samples. Mean (SD) activity was 19.6 (4.64) mU/mg of protein. Placental hexokinase activity correlated positively with prepregnancy body mass index (Spearman's rho (ρ)=0.33; P=0.006). Upon controlling for hours of fasting, hexokinase activity showed positive correlations with both maternal glucose (r=0.30; P=0.01) and insulin (r=0.28; P=0.02). Hexokinase activity was positively correlated with uteroplacental glucose uptake (ρ=0.31; P=0.01) and consumption (ρ=0.28; P=0.02). Hexokinase activity did not correlate with fetal glucose uptake. Upon controlling for placental weight, hexokinase activity showed a positive correlation with birth weight (r=0.31; P=0.01). CONCLUSION Our findings suggest that placental hexokinase, being crucial for uteroplacental retention of glucose for own disposition, is related to both maternal body mass index and birth weight independent of placental weight. Placental hexokinase may play a central role in the relationship between maternal glucose dysregulation and fetal growth. Thus, the current study supports the need to develop clinically useful tools to assess the metabolic properties of the placenta.
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Affiliation(s)
- Muhammad Umar Sajjad
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Tore Henriksen
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marie Cecilie P Roland
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Fetal Medicine, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - Trond M Michelsen
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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Arntzen T, Mikkelsen A, Emblem R, Lai X, Haugen G. Prenatal Diagnosis of Esophageal Atresia - Performance and Consequences. J Pediatr Surg 2023; 58:2075-2080. [PMID: 37407414 DOI: 10.1016/j.jpedsurg.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/25/2023] [Accepted: 05/14/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Prenatal diagnosis of congenital malformations is considered favorable. Esophageal atresia (EA) is prenatally detected in 10-40% of patients. The aims of our study were to assess factors influencing the prenatal detection rate and to study the outcome in EA patients with and without prenatal diagnosis. METHOD We included 136 patients in two time periods, group 1 (1996-2002, n = 68) and group 2 (2014-2020, n = 68). We registered clinical variables; prenatal signs, perinatal and postnatal outcome from the electronic patient record. RESULTS Twenty-five patients (18%) had a prenatal diagnosis of EA, significantly more during 2014-2020 (28%), than during 1996-2002 (9%). Patients with EA type A or B and with associated anomalies had increased likelihood of prenatal diagnosis, odds ratio (OR) 9.00 (1.99-40.69) and 3.53 (1.24-10.06), respectively. Among the 25 patients with prenatal diagnosis all had polyhydramnios and 16 had small/absent stomach. Prenatally diagnosed patients arrived significantly earlier at the surgical unit (median 2 h (2 h-1 days) vs 21 h (2 h-1275 days)), had more delayed primary anastomosis (OR 8.80 (2.68-28.92)) and anastomotic stricture (OR 3.11 (1.20-8.04)), longer length of stay (median 62 days (11-212 days) vs 20 days (2-270 days)) and longer time on ventilator (median 5 days (1-25 days) vs 1.5 days (0.5-33 days)) compared to patients without prenatal diagnosis. In multivariate analysis prenatal diagnosis predicts length of stay. CONCLUSION Prenatally diagnosed EA patients have more; type A and B malformations, associated anomalies and neonatal morbidity. Consequences of the assumed benefits of prenatal diagnosis; opportunity of early arrival to surgical care and prenatal counselling, must be further studied.
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Affiliation(s)
- T Arntzen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Section for Pediatric Surgery, Oslo University Hospital, Oslo, Norway.
| | - A Mikkelsen
- Section for Pediatric Surgery, Oslo University Hospital, Oslo, Norway
| | - R Emblem
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Section for Pediatric Surgery, Oslo University Hospital, Oslo, Norway
| | - X Lai
- Oslo Centre for Biostatistics and Epidemiology, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - G Haugen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Fetal Medicine, Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
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Färdig M, Lie A, Borres MP, Ekenkrantz T, Granum B, Haugen G, Jonassen CM, Movérare R, Rehbinder EM, Skjerven HO, Cathrine A, Vettukattil R, Lødrup Carlsen KC, Söderhäll C, Nordlund B. Eosinophil-derived neurotoxin levels in early childhood and association with preschool asthma - A prospective observational study. Clin Exp Allergy 2023; 53:1198-1211. [PMID: 37795650 DOI: 10.1111/cea.14409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 09/01/2023] [Accepted: 09/19/2023] [Indexed: 10/06/2023]
Abstract
INTRODUCTION Eosinophil-derived neurotoxin (EDN) is related to childhood asthma, while normal values are lacking. We aimed to document serum EDN levels at 1 and 3 years in general and in non-atopic children, and explore if EDN levels differed by sex or were associated with preschool asthma at 3 years. METHODS From the PreventADALL birth cohort, we included 1233 children with EDN analysed using ImmunoCAP at 1 and/or 3 years. Non-atopic children had no history of wheeze, asthma, allergic sensitization or atopic dermatitis. Preschool asthma was defined as having ≥3 episodes of bronchial obstruction between 2 and 3 years, plus doctor diagnosed asthma and/or asthma medication use by 3 years. The upper limit of normal (ULN) of EDN was defined as the 95th percentile. With Youden Index we calculated EDN cut-off levels for risk of preschool asthma. RESULTS The overall median (ULN) EDN levels were 27.4 (121) μg/L at 1 year (n = 787), and 20.1 (87.8) μg/L at 3 years (n = 857). Non-atopic children had EDN levels of 24.0 (107) μg/L at 1 year (n = 147), and 17.3 (84.6) μg/L at 3 years (n = 173). EDN levels were higher in boys compared to girls; 32.0 (133) versus 24.5 (97.0) μg/L at 1 year, and 20.9 (96.3) versus 19.0 (72.4) μg/L at 3 years. Preschool asthma was observed in 109/892 (12.2%) children. Higher EDN levels at 1 (>26.7 μg/L) and 3 (≥20.5 μg/L) years were associated with preschool asthma; adjusted OR (95% CI) 2.20 (1.09, 4.41) and 4.68 (2.29, 9.55), respectively. CONCLUSION AND CLINICAL RELEVANCE We report EDN values in early childhood, demonstrating higher levels at 1 compared to 3 years and in boys compared to girls at both ages. Higher EDN levels at both ages were associated with preschool asthma. However, EDN cut-off levels for preschool asthma were overall lower than the ULN of non-atopic children, limiting translation into clinical practice.
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Affiliation(s)
- Martin Färdig
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anine Lie
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Magnus P Borres
- Thermo Fisher Scientific, Uppsala, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Berit Granum
- Department of Chemical Toxicology, Norwegian Institute of Public Health, Oslo, Norway
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Christine M Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Robert Movérare
- Thermo Fisher Scientific, Uppsala, Sweden
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Eva Maria Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway
| | - Håvard O Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Björn Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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7
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Hoel ST, Wiik J, Carlsen KC, Endre KM, Gudmundsdóttir HK, Haugen G, Hoyer A, Jonassen CM, LeBlanc M, Nordlund B, Rudi K, Skjerven HO, Staff AC, Hedlin G, Söderhäll C, Vettukattil R, Aaneland H, Rehbinder EM. Birth mode is associated with development of atopic dermatitis in infancy and early childhood. J Allergy Clin Immunol Glob 2023; 2:100104. [PMID: 37779526 PMCID: PMC10509990 DOI: 10.1016/j.jacig.2023.100104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/15/2023] [Accepted: 02/05/2023] [Indexed: 10/03/2023]
Abstract
Background Birth by caesarean section (CS) is associated with development of allergic diseases, but its role in the development of atopic dermatitis (AD) is less convincing. Objective Our primary aim was to determine if birth mode was associated with AD in 3-year-olds and secondarily to determine if birth mode was associated with early onset and/or persistent AD in the first 3 years of life. Methods We included 2129 mother-child pairs from the Scandinavian population-based prospective PreventADALL cohort with information on birth mode including vaginal birth, either traditional (81.3%) or in water (4.0%), and CS before (6.3%) and after (8.5%) onset of labor. We defined early onset AD as eczema at 3 months and AD diagnosis by 3 years of age. Persistent AD was defined as eczema both in the first year and at 3 years of age, together with an AD diagnosis by 3 years of age. Results AD was diagnosed at 3, 6, 12, 24, and/or 36 months in 531 children (25%). Compared to vaginal delivery, CS was overall associated with increased odds of AD by 3 years of age, with adjusted odds ratio (95% confidence interval) of 1.33 (1.02-1.74), and higher odds of early onset AD (1.63, 1.06-2.48). The highest odds for early onset AD were observed in infants born by CS after onset of labor (1.83, 1.09-3.07). Birth mode was not associated with persistent AD. Conclusion CS was associated with increased odds of AD by 3 years of age, particularly in infants presenting with eczema at 3 months of age.
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Affiliation(s)
- Sveinung T. Hoel
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Johanna Wiik
- Department of Gynecology and Obstetrics, Østfold Hospital Trust, Kalnes, Norway
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Karin C.L. Carlsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Kim M.A. Endre
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Dermatology and Vaenerology, Oslo University Hospital, Oslo, Norway
| | - Hrefna Katrín Gudmundsdóttir
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Angela Hoyer
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
| | - Christine Monceyron Jonassen
- Centre for Laboratory Medicine, Østfold Hospital Trust, Grålum, Norway
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Marissa LeBlanc
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Håvard O. Skjerven
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
| | - Cilla Söderhäll
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
| | - Riyas Vettukattil
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Hilde Aaneland
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Eva M. Rehbinder
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Dermatology and Vaenerology, Oslo University Hospital, Oslo, Norway
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8
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Nestaas E, Bjarkø L, Kiserud T, Haugen G, Fugelseth D. Heart function by M-mode and tissue Doppler in the early neonatal period in neonates with fetal growth restriction. Early Hum Dev 2023; 183:105809. [PMID: 37331046 DOI: 10.1016/j.earlhumdev.2023.105809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Fetal growth restricted (FGR) neonates have increased risk of circulatory compromise due to failure of normal transition of circulation after birth. AIM Echocardiographic assessment of heart function in FGR neonates first three days after birth. STUDY DESIGN Prospective observational study. SUBJECTS FGR- and non-FGR neonates. OUTCOME MEASURES M-mode excursions and pulsed-wave tissue Doppler velocities normalised for heart size and E/e' of the atrioventricular plane day one, two and three after birth. RESULTS Compared with controls (non-FGR of comparable gestational age, n = 41), late-FGR (gestational age ≥ 32 weeks, n = 21) exhibited higher septal excursion (15.9 (0.6) vs. 14.0 (0.4) %, p = 0.021) (mean (SEM)) and left E/e' (17.3 (1.9) vs.11.5 (1.3), p = 0.019). Relative to day three, indexes on day one were higher for left excursion (21 (6) % higher on day one, p = 0.002), right excursion (12 (5) %, p = 0.025), left e' (15 (7) %, p = 0.049), right a' (18 (6) %, p = 0.001), left E/e' (25 (10) %, p = 0.015) and right E/e' (17 (7) %, p = 0.013), whereas no index changed from day two to day three. Late-FGR had no impact on changes from day one and two to day three. No measurements differed between early-FGR (n = 7) and late-FGR. CONCLUSIONS FGR impacted neonatal heart function the early transitional days after birth. Late-FGR hearts had increased septal contraction and reduced left diastolic function compared with controls. The dynamic changes in heart function between first three days were most evident in lateral walls, with similar pattern in late-FGR and non-FGR. Early-FGR and late-FGR exhibited similar heart function.
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Affiliation(s)
- Eirik Nestaas
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Clinic of Paediatrics and Adolescence, Akershus University Hospital, Lørenskog, Norway.
| | - Lisa Bjarkø
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Torvid Kiserud
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Fetal Medicine, Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Drude Fugelseth
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
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9
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Nilsen M, Rehbinder EM, Lødrup Carlsen KC, Haugen G, Hedlin G, Jonassen CM, Killingstad ME, Nordlund B, Ormaasen I, Skjerven HO, Snipen L, Staff AC, Söderhäll C, Sørensen R, Vettukattil R, Wilborn LM, Rudi K. A Globally Distributed Bacteroides caccae Strain Is the Most Prevalent Mother-Child Shared Bacteroidaceae Strain in a Large Scandinavian Cohort. Appl Environ Microbiol 2023; 89:e0078923. [PMID: 37338379 PMCID: PMC10370313 DOI: 10.1128/aem.00789-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 05/28/2023] [Indexed: 06/21/2023] Open
Abstract
Bacteroides and Phocaeicola, members of the family Bacteroidaceae, are among the first microbes to colonize the human infant gut. While it is known that these microbes can be transmitted from mother to child, our understanding of the specific strains that are shared and potentially transmitted is limited. In this study, we aimed to investigate the shared strains of Bacteroides and Phocaeicola in mothers and their infants. We analyzed fecal samples from pregnant woman recruited at 18 weeks of gestation from the PreventADALL study, as well as offspring samples from early infancy, including skin swab samples taken within 10 min after birth, the first available fecal sample (meconium), and fecal samples at 3 months of age. We screened 464 meconium samples for Bacteroidaceae, with subsequent selection of 144 mother-child pairs for longitudinal analysis, based on the presence of Bacteroidaceae, longitudinal sample availability, and delivery mode. Our results showed that Bacteroidaceae members were mainly detected in samples from vaginally delivered infants. We identified high prevalences of Phocaeicola vulgatus, Phocaeicola dorei, Bacteroides caccae, and Bacteroides thetaiotaomicron in mothers and vaginally born infants. However, at the strain level, we observed high prevalences of only two strains: a B. caccae strain and a P. vulgatus strain. Notably, the B. caccae strain was identified as a novel component of mother-child shared strains, and its high prevalence was also observed in publicly available metagenomes worldwide. Our findings suggest that mode of delivery may play a role in shaping the early colonization of the infant gut microbiota, in particular the colonization of Bacteroidaceae members. IMPORTANCE Our study provides evidence that Bacteroidaceae strains present on infants' skin within 10 min after birth, in meconium samples, and in fecal samples at 3 months of age in vaginally delivered infants are shared with their mothers. Using strain resolution analyses, we identified two strains, belonging to Bacteroides caccae and Phocaeicola vulgatus, as shared between mothers and their infants. Interestingly, the B. caccae strain showed a high prevalence worldwide, while the P. vulgatus strain was less common. Our findings also showed that vaginal delivery was associated with early colonization of Bacteroidaceae members, whereas cesarean section delivery was associated with delayed colonization. Given the potential for these microbes to influence the colonic environment, our results suggest that understanding the bacterial-host relationship at the strain level may have implications for infant health and development later in life.
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Affiliation(s)
- Morten Nilsen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Eva Maria Rehbinder
- Department of Dermatology and Vaenerology, Oslo University Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | - Karin C. Lødrup Carlsen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Björn Nordlund
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Ida Ormaasen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Håvard O. Skjerven
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Lars Snipen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Anne Cathrine Staff
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Regina Sørensen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Riyas Vettukattil
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Lene Marie Wilborn
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
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10
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Hilde K, Gudmundsdóttir HK, Bains KES, Carlsen KCL, Färdig M, Jonassen CM, Kreyberg I, LeBlanc M, Nordlund B, Rehbinder EM, Roland MCP, Skjerven HO, Staff AC, Vettukattil R, Haugen G. Third trimester fetal lung volume, thoracic circumference, and early infant lung function. Pediatr Pulmonol 2023. [PMID: 37098847 DOI: 10.1002/ppul.26431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/27/2023] [Accepted: 04/16/2023] [Indexed: 04/27/2023]
Abstract
BACKGROUND We aimed to investigate the relationship between fetal third trimester lung volume (LV), thoracic circumference (TC), fetal weight, as well as fetal thoracic and weight growth, and early infant lung function. METHODS Fetal LV, TC and estimated weight were measured with ultrasound at 30 gestational weeks in 257 fetuses from the general population-based prospective cohort study Preventing Atopic Dermatitis and ALLergies in Children (PreventADALL). Fetal thoracic growth rate and weight increase were calculated using TC and estimated fetal weight measured by ultrasound during pregnancy, and TC and birthweight of the newborn. Lung function was assessed by tidal flow-volume measurement in awake infants at 3 months of age. The associations between fetal size (LV, TC, and estimated weight) and growth (thoracic growth rate and fetal weight increase) measures and the time to peak tidal expiratory flow to expiratory time ratio (tPTEF /tE ) as well as tidal volume standardized for body weight (VT /kg) were analyzed using linear and logistic regression models. RESULTS We observed no associations between fetal LV, TC or estimated fetal weight and tPTEF /tE as a continuous variable, tPTEF /tE < 25th percentile, or VT /kg. Similarly, fetal thoracic growth and weight increase were not associated with infant lung function. Analyses stratified for sex showed a significant inverse association between fetal weight increase and VT /kg (p = 0.02) in girls. CONCLUSION Overall, fetal third trimester LV, TC, estimated fetal weight, thoracic growth rate and weight increase were not associated with infant lung function at 3 months of age.
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Affiliation(s)
- Katarina Hilde
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Hrefna Katrín Gudmundsdóttir
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karen Eline S Bains
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Martin Färdig
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Christine M Jonassen
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Ina Kreyberg
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Marissa LeBlanc
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Björn Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Maria Rehbinder
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Dermatology and Vaenerology, Oslo University Hospital, Oslo, Norway
| | | | - Håvard O Skjerven
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
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11
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Wiik J, Værnesbranden MR, Jonassen CM, Staff AC, Carlsen KCL, Granum B, Haugen G, Hedlin G, Hilde K, Jacobsson B, Nilsson S, Nordlund B, Rangberg A, Rehbinder EM, Sengpiel V, Skjerven H, Sundet BK, Söderhäll C, Vettukattil R, Sjøborg K. Maternal human papillomavirus infection during pregnancy and preterm delivery: A mother-child cohort study in Norway and Sweden. Acta Obstet Gynecol Scand 2023; 102:344-354. [PMID: 36647213 PMCID: PMC9951315 DOI: 10.1111/aogs.14509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Human papillomavirus (HPV) infection is common in women of reproductive age. Infection and inflammation are leading causes for preterm delivery (PTD), but the role of HPV infection in PTD and prelabor rupture of membranes (PROM) is unclear. We aimed to explore whether HPV infection during pregnancy in general, and high-risk-HPV (HR-HPV) infection specifically, increased the risk of PTD, preterm prelabor rupture of membranes (PPROM), PROM at term, and/or chorioamnionitis. MATERIAL AND METHODS In pregnant women, who were participating in a prospective multicenter cohort study from a general population in Norway and Sweden (PreventADALL, ClinicalTrials.gov NCT02449850), HPV DNA was analyzed in available urine samples at mid-gestation (16-22 weeks) and at delivery, and in the placenta after delivery with Seegene Anyplex II HPV28 PCR assay. The risk of PTD, PPROM, PROM, and chorioamnionitis was analyzed using unadjusted and adjusted logistic regression analyses for any 28 HPV genotypes, including 12 HR-HPV genotypes, compared with HPV-negative women. Further, subgroups of HPV (low-risk/possibly HR-HPV, HR-HPV-non-16 and HR-HPV-16), persistence of HR-HPV from mid-gestation to delivery, HR-HPV-viral load, and presence of multiple HPV infections were analyzed for the obstetric outcomes. Samples for HPV analyses were available from 950 women with singleton pregnancies (mean age 32 years) at mid-gestation and in 753 also at delivery. RESULTS At mid-gestation, 40% of women were positive for any HPV and 24% for HR-HPV. Of the 950 included women, 23 had PTD (2.4%), nine had PPROM (0.9%), and six had chorioamnionitis (0.6%). Of the term pregnancies, 25% involved PROM. The frequency of PTD was higher in HR-HPV-positive women (8/231, 3.5%) than in HPV-negative women (13/573, 2.3%) at mid-gestation, but the association was not statistically significant (odds ratio 1.55; 95% confidence interval 0.63-3.78). Neither any HPV nor subgroups of HPV at mid-gestation or delivery, nor persistence of HR-HPV was significantly associated with increased risk for PTD, PPROM, PROM, or chorioamnionitis. No HPV DNA was detected in placentas of women with PTD, PPROM or chorioamnionitis. CONCLUSIONS HPV infection during pregnancy was not significantly associated with increased risk for PTD, PPROM, PROM, or chorioamnionitis among women from a general population with a low incidence of adverse obstetric outcomes.
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Affiliation(s)
- Johanna Wiik
- Department of Gynecology and ObstetricsØstfold Hospital TrustGralumNorway,Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Obstetrics and GynecologySahlgrenska University HospitalGothenburgSweden
| | - Magdalena R. Værnesbranden
- Department of Gynecology and ObstetricsØstfold Hospital TrustGralumNorway,Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
| | - Christine M. Jonassen
- Department of Virology, Norwegian Institute of Public Health OsloOsloNorway,Genetic Unit, Center for Laboratory MedicineØstfold Hospital TrustGralumNorway
| | - Anne Cathrine Staff
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway,Division of Obstetrics and GynecologyOslo University HospitalOsloNorway
| | - Karin C. L. Carlsen
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway,Division of Pediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Berit Granum
- Department of Chemical Toxicology, Norwegian Institute of Public HealthOsloNorway
| | - Guttorm Haugen
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway,Division of Obstetrics and GynecologyOslo University HospitalOsloNorway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University HospitalStockholmSweden,Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Katarina Hilde
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway,Division of Obstetrics and GynecologyOslo University HospitalOsloNorway
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Obstetrics and GynecologySahlgrenska University HospitalGothenburgSweden,Department of Genetics and Bioinformatics, Division of Health Data and Digitalization, Institute of Public HealthOsloNorway
| | - Staffan Nilsson
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Mathematical SciencesChalmers University of TechnologyGothenburgSweden
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University HospitalStockholmSweden,Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Anbjørg Rangberg
- Genetic Unit, Center for Laboratory MedicineØstfold Hospital TrustGralumNorway
| | - Eva Maria Rehbinder
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway,Department of Dermatology and VenereologyOslo University HospitalOsloNorway
| | - Verena Sengpiel
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Obstetrics and GynecologySahlgrenska University HospitalGothenburgSweden
| | - Håvard Skjerven
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway,Division of Pediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Birgitte K. Sundet
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway,Division of Obstetrics and GynecologyOslo University HospitalOsloNorway
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University HospitalStockholmSweden,Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Riyas Vettukattil
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway,Division of Pediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Katrine Sjøborg
- Department of Gynecology and ObstetricsØstfold Hospital TrustGralumNorway
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12
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Gudmundsdóttir HK, Hilde K, Bains KES, Färdig M, Haugen G, LeBlanc M, Nordhagen LS, Nordlund B, Rehbinder EM, Skjerven HO, Staff AC, Vettukattil R, Carlsen KCL. Fetal thoracic circumference in mid-pregnancy and infant lung function. Pediatr Pulmonol 2023; 58:35-45. [PMID: 36097818 PMCID: PMC10091718 DOI: 10.1002/ppul.26153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/22/2022] [Accepted: 09/05/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIM Impaired lung function in early infancy is associated with later wheeze and asthma, while fetal thoracic circumference (TC) predicts severity of neonatal lung hypoplasia. Exploring fetal origins of lung function in infancy, we aimed to determine if fetal TC in mid-pregnancy was associated with infant lung function. METHODS From the prospective Scandinavian general population-based PreventADALL mother-child birth cohort, all 851 3-month-old infants with tidal flow-volume measurements in the awake state and ultrasound fetal size measures at 18 (min-max 16-22) weeks gestational age were included. Associations between fetal TC and time to peak tidal expiratory flow to expiratory time (tPTEF /tE ) were analyzed in linear regression models. To account for gestational age variation, we adjusted TC for simultaneously measured general fetal size, by head circumference (TC/HC), abdominal circumference (TC/AC), and femur length (TC/FL). Multivariable models were adjusted for maternal age, maternal asthma, pre-pregnancy body mass index, parity, nicotine exposure in utero, and infant sex. RESULTS The infants (47.8% girls) were born at mean (SD) gestational age of 40.2 (1.30) weeks. The mean (SD) tPTEF /tE was 0.39 (0.08). The mean (SD) TC/HC was 0.75 (0.04), TC/AC 0.87 (0.04), and TC/FL 4.17 (0.26), respectively. Neither TC/HC nor TC/AC were associated with infant tPTEF /tE while a week inverse association was observed between TC/FL and tPTEF /tE ( β ^ $\hat{\beta }$ = -0.03, 95% confidence interval [-0.05, -0.007], p = 0.01). CONCLUSION Mid-pregnancy fetal TC adjusted for fetal head or abdominal size was not associated with tPTEF /tE in healthy, awake 3-month-old infants, while a weak association was observed adjusting for fetal femur length.
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Affiliation(s)
- Hrefna K Gudmundsdóttir
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Katarina Hilde
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Karen E S Bains
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Martin Färdig
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Guttorm Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Marissa LeBlanc
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Live S Nordhagen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Health, VID Specialized University, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Eva M Rehbinder
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology and Venereology, Oslo University Hospital, Oslo, Norway
| | - Håvard O Skjerven
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne C Staff
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karin C L Carlsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
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13
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Oftedal A, Bekkhus M, Haugen G, Hjemdal O, Czajkowski NO, Kaasen A. Long-Term Impact of Diagnosed Fetal Anomaly on Parental Traumatic Stress, Resilience, and Relationship Satisfaction. J Pediatr Psychol 2022; 48:181-192. [PMID: 36399086 PMCID: PMC9941832 DOI: 10.1093/jpepsy/jsac085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 10/18/2022] [Accepted: 10/18/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Knowledge regarding the long-term psychological adjustment of parents to children with prenatal diagnosis of congenital malformation is scarce. The aim of this study is to examine traumatic stress trajectories, resilience, and relationship satisfaction among parents to children with prenatal diagnosis of a congenital malformation, and to compare this to a sample of non-affected parents. METHODS A prospective longitudinal cohort study was conducted at a tertiary perinatal referral center. Ninety-three mothers and 80 fathers who received a diagnosis of fetal anomaly during obstetric ultrasound examination (study group), and 110 mothers and 98 fathers with normal ultrasound findings (comparison group), reported their traumatic stress at four timepoints during pregnancy (T1-T4), 6 weeks after birth (T5), and 10-12 years after birth (T6). Resilience and relationship satisfaction was reported at 10-12 years after birth. RESULTS Parents to children with a congenital malformation experienced significantly elevated traumatic stress levels over time, compared with parents of children without congenital malformation. The difference between groups was largest acutely after diagnosis and remained significant 10-12 years after the birth of the child. Resilience and relationship satisfaction levels were similar in both groups. CONCLUSIONS Despite experiencing high levels of traumatic stress over time, parents to children with a congenital malformation reported resilience and relationship satisfaction at similar levels to non-affected parents. This suggests that despite ongoing long-term distress, parents are still able to maintain positive psychological coping resources.
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Affiliation(s)
- Aurora Oftedal
- All correspondence concerning this article should be addressed to Aurora Oftedal, Faculty of Health Science, Oslo Metropolitan University, Pilestredet 32, 0166 Oslo, Norway. E-mail:
| | - Mona Bekkhus
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Guttorm Haugen
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Nikolai Olavi Czajkowski
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway,Department of Mental Disorders, Norwegian Institute of Public Health, Norway
| | - Anne Kaasen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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14
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Gudmundsdóttir HK, Carlsen OCL, Bains KES, Färdig M, Haugen G, Jonassen CM, LeBlanc M, Nordlund B, Rehbinder EM, Skjerven HO, Staff AC, Vettukattil R, Lødrup Carlsen KC. Infant lung function and maternal physical activity in the first half of pregnancy. ERJ Open Res 2022; 8:00172-2022. [PMID: 36329799 PMCID: PMC9619250 DOI: 10.1183/23120541.00172-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/14/2022] [Indexed: 11/07/2022] Open
Abstract
Background and aim Physical activity (PA) in pregnancy is important for maternal and possibly offspring health. To study the early origins of lung function we aimed to determine whether PA in the first half of pregnancy is associated with lung function in healthy 3-month-old infants. Methods From the general population-based Preventing Atopic Dermatitis and Allergies in Children birth cohort recruiting infants antenatally in Norway and Sweden, all 812 infants (48.8% girls) with available tidal flow-volume measures in the awake state at 3 months of age and mid-pregnancy data on PA were included. PA was self-reported by the mothers and, based on intensity, we categorised them as active or inactive during pregnancy. Furthermore, we defined active mothers as fairly or highly active. The main outcome was a ratio of time to peak tidal expiratory flow to expiratory time (t PTEF/t E) <0.25. Associations were analysed by logistic regression, adjusting for maternal age, education, parity, pre-pregnancy body mass index, in utero nicotine exposure and parental atopy. Results The mean±sd t PTEF/t E was 0.391±0.08 and did not differ significantly according to maternal PA level in pregnancy. The 290 infants of inactive mothers had higher odds of having t PTEF/t E <0.25 compared to infants of all active mothers (OR 2.07, 95% CI 1.13-3.82; p=0.019) and compared to infants (n=224) of fairly active (OR 2.83, 95% CI 1.26-7.24; p=0.018) but not highly active mothers (n=298). Conclusion Based on self-reported maternal PA in the first half of pregnancy, 3-month-old infants of inactive compared to active mothers had higher odds of a low t PTEF/t E.
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Affiliation(s)
- Hrefna Katrín Gudmundsdóttir
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Oda C L Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karen Eline Stensby Bains
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Martin Färdig
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Guttorm Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Christine M Jonassen
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway.,Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - Marissa LeBlanc
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Eva Maria Rehbinder
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology and Venereology, Oslo University Hospital, Oslo, Norway
| | - Håvard O Skjerven
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
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15
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Henriksen T, Roland MCP, Sajjad MU, Haugen G, Michelsen TM. Uteroplacental versus fetal use of glucose in healthy pregnancies at term. A human in vivo study. Placenta 2022; 128:116-122. [PMID: 36162142 DOI: 10.1016/j.placenta.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 08/11/2022] [Accepted: 09/04/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Fetal glucose is thought to originate from maternal glucose driven across the placenta by a maternal-fetal glucose gradient. Still, there is no correlation between the mass of glucose taken up by the uteroplacenta and the fetal uptake. We propose a hypothesis that the uteroplacenta's own treatment of glucose affects the net mass of glucose taken up by the fetus, independent of the maternal-fetal gradient. METHODS We performed a human in vivo study of term uncomplicated pregnancies including seventy healthy women delivered by scheduled cesarean delivery. We measured uterine and umbilical blood flow by Doppler ultrasonography, and glucose concentrations in the maternal radial artery, uterine vein, umbilical artery and vein. We calculated Spearman's correlations between uteroplacental and fetal glucose uptake within tertiles of placental glucose consumption. RESULTS There were significant correlations between uteroplacental uptake and fetal uptake of glucose when determined within each tertile (Spearman's rho 0.76, (p < 0.001); 0.94 (p < 0.001) and 0.49 (p = 0.029) from lowest to highest tertile, respectively). The median (Q1, Q3) uteroplacental glucose consumption in each tertile was -88.8 (-140.3, 56.7), 29.7 (9.2, 47.4) and 174.7 (87.8, 226.1) (μmol/min). The corresponding median (Q1, Q3) fetal glucose uptake was 152.9 (94.2, 162.7), 110.8 (54.7, 167.2) and 66.6 (8.5, 122.1) (μmol/min). DISCUSSION The maternal fetal glucose gradients were similar in the tertiles of placental glucose consumption. Still, the net mass of glucose taken up by the fetus was markedly different between the tertiles. Placental treatment of glucose exhibited a large variation from apparent production to consumption.
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Affiliation(s)
- Tore Henriksen
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Marie Cecilie P Roland
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Muhammad Umar Sajjad
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Fetal Medicine, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - Trond M Michelsen
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
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16
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Zahid SM, Opheim GL, Henriksen T, Michelsen TM, Haugen G. Effect of a standardized maternal meal on fetal middle cerebral artery Doppler indices: A single-blinded crossover study. PLoS One 2022; 17:e0272062. [PMID: 35925970 PMCID: PMC9352093 DOI: 10.1371/journal.pone.0272062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/12/2022] [Indexed: 11/18/2022] Open
Abstract
Objective Measures of Doppler blood flow velocity profiles are an integral part of monitoring fetal well-being during pregnancy. These examinations are performed at different times of the day and at different maternal meal states. In uncomplicated pregnancies, we assessed the effect of a standardized maternal meal on middle cerebral artery (MCA) and umbilical artery (UA) Doppler blood flow velocity pulsatility indices (PIs) and MCA peak systolic velocity (PSV). Methods In this prospective single-blinded crossover study 25 healthy women were examined at 36 weeks of pregnancy. The first examination was performed in the morning following overnight fast, and repeated after extended fast (state A), and after a standard breakfast meal (state B). Results Irrespective of maternal prandial status, the MCA-PI values were lower in the 2nd compared to the 1st examination (-0.187; p = 0.071, and -0.113; p = 0.099, state A and B, respectively). Compared to the values in the 1st examination, the UA-PI values, were higher after extended fast (0.014; p = 0.436), and lower post-prandially (-0.036; p = 0.070). The difference (state B minus state A) between the meal states were not significant (0.074; p = 0.487 and -0.050; p = 0.058, for MCA-PI and UA-PI, respectively). Adjusting for the possible influence of fetal heart rate on MCA-PI and UA-PI, the differences between meal states remained non-significant (p = 0.179, p = 0.064, respectively). The MCA-PSV values increased after the meal (6.812; p = 0.035), whereas no increase was observed following extended fast (0.140; p = 0.951). The difference in MCA-PSV values between the two meal states was not significant (6.672; p = 0.055). Conclusion Our results demonstrate possible diurnal variations in MCA-PI and UA-PI, with and without adjustment for fetal heart rate, that seem to be unaffected by maternal meal intake in healthy pregnancies.
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Affiliation(s)
- Saba Muneer Zahid
- Division of Obstetrics and Gynaecology, Department of Fetal Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- * E-mail:
| | - Gun Lisbet Opheim
- Division of Obstetrics and Gynaecology, Department of Fetal Medicine, Oslo University Hospital, Oslo, Norway
| | - Tore Henriksen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Department of Obstetrics, Oslo University Hospital, Oslo, Norway
| | - Trond Melbye Michelsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Department of Obstetrics, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- Division of Obstetrics and Gynaecology, Department of Fetal Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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17
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Nordhagen LS, Løfsgaard VS, Småstuen MC, Glavin K, Carlsen K, Carlsen MH, Granum B, Gubrandsgard M, Haugen G, Hedlin G, Jonassen CM, Nordlund B, Rehbinder EM, Rudi K, Saunders CM, Skjerven HO, Staff AC, Söderhäll C, Vettukattil R, Aaneland H, Lødrup Carlsen KC. Maternal food-avoidance diets and dietary supplements during breastfeeding. Nurs Open 2022; 10:230-240. [PMID: 35866582 PMCID: PMC9748056 DOI: 10.1002/nop2.1298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 05/18/2022] [Accepted: 06/27/2022] [Indexed: 01/04/2023] Open
Abstract
AIMS To identify maternal food-avoidance diets and dietary supplement use during breastfeeding, and to explore factors associated with food avoidance diets. DESIGN A prospective mother-child birth cohort study. METHODS Electronic questionnaires were answered by 1,462 breastfeeding mothers 6 months postpartum in the Preventing Atopic Dermatitis and Allergies in Children (PreventADALL) study from 2014-2016. Demographic and antenatal factors were analysed for associations with food avoidance diets in 1,368 women by multiple logistic regression. RESULTS Overall, 289 breastfeeding women (19.8%) avoided at least one food item in their diet, most commonly cow's milk in 99 women (6.8%). Foods were most often avoided due to conditions in the child, maternal factors or lifestyle choice. The odds for food avoidance diets were 2.1 (95% CI: 1.3, 3.4) for food allergy (presumed or diagnosed) and 19.4 (5.4, 70.1) for celiac disease in the mother. Dietary supplements were reported by nearly 80%, most commonly cod liver oil.
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Affiliation(s)
- Live S. Nordhagen
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway,VID Specialized UniversityOsloNorway
| | | | | | | | | | | | - Berit Granum
- Department of Environmental HealthNorwegian Institute of Public HealthOsloNorway
| | - Malén Gubrandsgard
- Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Guttorm Haugen
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Obstetrics and GynaecologyOslo University HospitalOsloNorway
| | - Gunilla Hedlin
- Astrid Lindgren Children's HospitalKarolinska University HospitalStockholmSweden,Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Christine M. Jonassen
- Faculty of Chemistry, Biotechnology and Food Scienceorwegian University of Life SciencesÅsNorway,Genetic Unit, Centre for Laboratory MedicineØstfold Hospital TrustNorway
| | - Björn Nordlund
- Astrid Lindgren Children's HospitalKarolinska University HospitalStockholmSweden,Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Eva Maria Rehbinder
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Department of Dermatology and VenerologyOslo University HospitalOsloNorway
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Scienceorwegian University of Life SciencesÅsNorway
| | - Carina M. Saunders
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Håvard O. Skjerven
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Anne Cathrine Staff
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Obstetrics and GynaecologyOslo University HospitalOsloNorway
| | - Cilla Söderhäll
- Astrid Lindgren Children's HospitalKarolinska University HospitalStockholmSweden,Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Riyas Vettukattil
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Hilde Aaneland
- Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Karin C. Lødrup Carlsen
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway
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18
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Sundet BK, Kreyberg I, Staff AC, Carlsen KCL, Bains KES, Berg JP, Granum B, Haugen G, Hedlin G, Jonassen CM, Nordhagen LS, Nordlund B, Rehbinder EM, Rudi K, Rueegg CS, Sjøborg KD, Skjerven HO, Söderhäll C, Vettukattil R, Sugulle M. The effect of nicotine-containing products and fetal sex on placenta-associated circulating midpregnancy biomarkers. Biol Sex Differ 2022; 13:39. [PMID: 35841068 PMCID: PMC9284818 DOI: 10.1186/s13293-022-00443-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 06/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background In utero exposure to nicotine, largely assessed by smoking, is a risk factor for impaired offspring health, while potential effects of non-combustible nicotine use such as snus (oral moist tobacco), are less well-known. Maternal serum concentrations of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) may be viewed as “placenta health markers”, known to differ by fetal sex. Maternal smoking during pregnancy has been associated with lower levels of circulating sFlt-1, while the effect of snus on placenta-associated angiogenic factors is unknown. Our aim was to explore if snus and/or smoking exposure was associated with midpregnancy maternal levels of sFlt-1, PlGF and sFlt-1/PlGF ratio if these associations were modified by fetal sex. Methods Midpregnancy (16–22 gestational weeks) serum from 2603 Scandinavian women enrolled in the population-based multi-center PreventADALL (Preventing Atopic Dermatitis and ALLergies in children) study was analysed for sFlt-1 and PlGF concentrations by electrochemiluminescence, deriving the sFlt-1/PGF ratio. Nicotine use was assessed by electronic questionnaires at enrollment in 2278 of the women. Univariable and multivariable linear regression models on log transformed outcomes were used to assess the association between nicotine use and biomarker levels. Interaction terms were included to identify whether the associations were modified by fetal sex. Results Median sFlt-1, PlGF and sFlt-1/PlGF ratios among women with nicotine exposure information were similar to those of all included women and differed by fetal sex. Current snus use was significantly associated with reduced maternal circulating PlGF levels in adjusted analyses [β − 0.12, (95% CI − 0.20; 0.00) compared to never use, p = 0.020]. A significant interaction between fetal sex and snus exposure was observed for PIGF (p = 0.031). Prior or periconceptional snus use was significantly associated with PIGF in male fetus pregnancies [β − 0.05 (95% CI − 0.09 to (− 0.02)) and β − 0.07 (95% CI − 0.12 to (− 0.02)) compared to never use, p = 0.002]. Smoking was not significantly associated with any circulating biomarkers levels. Conclusions Midpregnancy maternal angiogenic profile differed by periconceptional snus use and fetal sex. Snus exposure, perceived as “safe” by users, before or during pregnancy seems to affect midpregnancy placental health in a sex dimorphic manner. Supplementary Information The online version contains supplementary material available at 10.1186/s13293-022-00443-1.
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Affiliation(s)
- Birgitte Kordt Sundet
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Nydalen, Postbox 4956, 0424, Oslo, Norway
| | - Ina Kreyberg
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Nydalen, Postbox 4956, 0424, Oslo, Norway
| | - Karin Cecilie Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karen Eline Stensby Bains
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Jens Petter Berg
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Berit Granum
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Nydalen, Postbox 4956, 0424, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Christine Monceyron Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway.,Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Live Solveig Nordhagen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,VID Specialized University, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Eva Maria Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Corina Silvia Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | | | - Håvard Ove Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Riyas Vettukattil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Meryam Sugulle
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. .,Division of Obstetrics and Gynaecology, Oslo University Hospital, Nydalen, Postbox 4956, 0424, Oslo, Norway.
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19
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Skjerven HO, Lie A, Vettukattil R, Rehbinder EM, LeBlanc M, Asarnoj A, Carlsen KH, Despriee ÅW, Färdig M, Gerdin SW, Granum B, Gudmundsdóttir HK, Haugen G, Hedlin G, Håland G, Jonassen CM, Landrø L, Mägi CAO, Olsen IC, Rudi K, Saunders CM, Skram MK, Staff AC, Söderhäll C, Tedner SG, Aadalen S, Aaneland H, Nordlund B, Lødrup Carlsen KC. Early food intervention and skin emollients to prevent food allergy in young children (PreventADALL): a factorial, multicentre, cluster-randomised trial. Lancet 2022; 399:2398-2411. [PMID: 35753340 DOI: 10.1016/s0140-6736(22)00687-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 03/04/2022] [Accepted: 04/03/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Primary prevention of food allergy by early introduction of allergenic foods seems promising. We aimed to determine whether early food introduction or the application of regular skin emollients in infants from a general population reduced the risk of food allergy. METHODS This 2 × 2 factorial, cluster-randomised trial was done at Oslo University Hospital and Østfold Hospital Trust, Oslo, Norway, and Karolinska University Hospital, Stockholm, Sweden. Infants of women recruited antenatally at the routine 18-week ultrasound examination were cluster-randomised at birth to the following groups: (1) no intervention group; (2) the skin intervention group (skin emollients; bath additives and facial cream; from age 2 weeks to <9 months, both at least four times per week); (3) the food intervention group (early complementary feeding of peanut, cow's milk, wheat, and egg from age 3 months); or (4) combined intervention group (skin and food interventions). Participants were randomly assigned (1:1:1:1) using computer-generated randomisation based on clusters of 92 geographical areas and eight 3-month time blocks. Study personnel performing clinical assessments were masked to group allocation. The primary outcome was allergy to any interventional food at 36 months of age. The primary efficacy analysis was done by intention-to-treat analysis, which included all participants who were randomly assigned, apart from three individuals who withdrew their consent. This was a study performed within ORAACLE (the Oslo Research Group of Asthma and Allergy in Childhood; the Lung and Environment). This study is registered as ClinicalTrials.gov, NCT02449850. FINDINGS We recruited 2697 women with 2701 pregnancies, from whom 2397 newborn infants were enrolled between April 14, 2015, and April 11, 2017. Of these infants, 597 were randomly assigned to the no intervention group, 575 to the skin intervention group, 642 to the food intervention group, and 583 to the combined intervention group. One participant in each of the no intervention, food intervention, and skin intervention groups withdrew consent and were therefore not included in any analyses. Food allergy was diagnosed in 44 children; 14 (2·3%) of 596 infants in the non-intervention group, 17 (3·0%) of 574 infants in the skin intervention group, six (0·9%) of 641 infants in the food intervention group, and seven (1·2%) of 583 infants in the combined intervention group. Peanut allergy was diagnosed in 32 children, egg allergy in 12 children, and milk allergy in four children. None had allergy to wheat. Prevalence of food allergy was reduced in the food intervention group compared with the no food intervention group (risk difference -1·6% [95% CI -2·7 to -0·5]; odds ratio [OR] 0·4 [95% CI 0·2 to 0·8]), but not compared with the skin intervention group (0·4% [95% CI -0·6 to 1· 5%]; OR 1·3 [0·7 to 2·3]), with no significant interaction effect (p=1·0). Preventing food allergy in one child required early exposure to allergenic foods in 63 children. No serious adverse events were observed. INTERPRETATION Exposure to allergenic foods from 3 months of age reduced food allergy at 36 months in a general population. Our results support that early introduction of common allergenic foods is a safe and effective strategy to prevent food allergy. FUNDING Full funding sources listed at end of paper (see Acknowledgments).
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Affiliation(s)
- Håvard Ove Skjerven
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Anine Lie
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Riyas Vettukattil
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Eva Maria Rehbinder
- Department of Dermatology, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marissa LeBlanc
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Anna Asarnoj
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Kai-Håkon Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Åshild Wik Despriee
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; VID Specialized University, Oslo, Norway
| | - Martin Färdig
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Sabina Wärnberg Gerdin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Berit Granum
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Hrefna Katrín Gudmundsdóttir
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Guttorm Haugen
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gunilla Hedlin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Geir Håland
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Christine Monceyron Jonassen
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway; Department of Pediatrics, Østfold Hospital Trust, Kalnes, Norway
| | - Linn Landrø
- Department of Dermatology, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Caroline-Aleksi Olsson Mägi
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | | | - Knut Rudi
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Carina Madelen Saunders
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marius Kurås Skram
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne Cathrine Staff
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Cilla Söderhäll
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Sandra G Tedner
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Sigve Aadalen
- Department of Pediatrics, Østfold Hospital Trust, Kalnes, Norway
| | - Hilde Aaneland
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Karin C Lødrup Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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20
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Olsson Mägi CA, Wik Despriee Å, Småstuen MC, Almqvist C, Bahram F, Bakkeheim E, Bjerg A, Glavin K, Granum B, Haugen G, Hedlin G, Jonassen CM, Lødrup Carlsen KC, Rehbinder EM, Rolfsjord LB, Staff AC, Skjerven HO, Vettukattil R, Nordlund B, Söderhäll C. Maternal Stress, Early Life Factors and Infant Salivary Cortisol Levels. Children 2022; 9:children9050623. [PMID: 35626800 PMCID: PMC9139396 DOI: 10.3390/children9050623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/09/2022] [Accepted: 04/20/2022] [Indexed: 11/30/2022]
Abstract
Background: Salivary cortisol (SC), a commonly used biomarker for stress, may be disrupted by negative events in pregnancy, at birth and in infancy. We aimed to explore if maternal perceived stress (PSS) in or after pregnancy and SC levels in pregnancy were associated with SC in early infancy, and, secondly, to identify early life factors associated with infants’ SC levels (iSC). Methods: At 3 months of age, SC was analyzed in 1057 infants participating in a Nordic prospective mother-child birth cohort study. Maternal PSS was available from questionnaires at 18- and 34-week gestational age (GA) and 3-month post-partum, and SC was analyzed at 18-week GA. Early life factors included sociodemographic and infant feeding from questionnaires, and birth data from medical charts. Associations to iSC were analyzed by Spearman correlation and multinomial logistic regression analyses. Results: In this exploratory study neither PSS at any time point nor maternal SC (mSC) were associated with iSC. Higher birth weight was associated with higher levels of iSC, while inverse associations were observed in infants to a mother not living with a partner and mixed bottle/breastfeeding. Conclusions: Maternal stress was not associated with iSC levels, while birth weight, single motherhood and infant feeding may influence iSC levels.
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Affiliation(s)
- Caroline-Aleksi Olsson Mägi
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
- Correspondence:
| | - Åshild Wik Despriee
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Faculty of Health, VID Specialized University, NO-0424 Oslo, Norway; (M.C.S.); (K.G.)
| | | | - Catarina Almqvist
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Fuad Bahram
- Research Centre, Stockholm South General Hospital, SE-118 83 Stockholm, Sweden;
| | - Egil Bakkeheim
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
| | - Anders Bjerg
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Martina Children’s Hospital, SE-114 86 Stockholm, Sweden
| | - Kari Glavin
- Faculty of Health, VID Specialized University, NO-0424 Oslo, Norway; (M.C.S.); (K.G.)
| | - Berit Granum
- Department of Chemical Toxicology, Norwegian Institute of Public Health, NO-0213 Oslo, Norway;
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Obstetrics and Gynaecology, Oslo University Hospital, NO-0424 Oslo, Norway
| | - Gunilla Hedlin
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
| | - Christine Monceyron Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, NO-1430 Ås, Norway;
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, NO-1714 Kalnes, Norway
| | - Karin C. Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
| | - Eva Maria Rehbinder
- Department of Dermatology and Vaenerology, Oslo University Hospital, NO-0424 Oslo, Norway;
| | - Leif-Bjarte Rolfsjord
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
- Department of Paediatric and Adolescent Medicine Elverum, Innlandet Hospital Trust, NO-2381 Brumunddal, Norway
| | - Anne Cathrine Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Obstetrics and Gynaecology, Oslo University Hospital, NO-0424 Oslo, Norway
| | - Håvard Ove Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
| | - Riyas Vettukattil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
| | - Björn Nordlund
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
| | - Cilla Söderhäll
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
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21
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Hilde K, Lødrup Carlsen KC, Bains KES, Gudmundsdóttir HK, Jonassen CM, Kreyberg I, LeBlanc M, Nordhagen L, Nordlund B, Rehbinder EM, Sjøborg KD, Skjerven HO, Staff AC, Sundet BK, Vettukattil R, Vaernesbranden MR, Wiik J, Haugen G. Fetal Thoracic Circumference and Lung Volume and Their Relation to Fetal Size and Pulmonary Artery Blood Flow. J Ultrasound Med 2022; 41:985-993. [PMID: 34289520 DOI: 10.1002/jum.15785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 06/17/2021] [Accepted: 07/03/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Research on early origins of lung disease suggests the need for studying the relationships of thoracic and lung size with fetal size and pulmonary circulation. The primary aim of this study is therefore to explore the associations between fetal thoracic circumference, lung volume, and fetal size. We also aim to assess if lung volume and thoracic circumference are associated with fetal pulmonary artery blood flow velocity measures. METHODS Cross-sectional assessment of singleton pregnancies from the general population (n = 447) at 30 gestational weeks (GW) was performed using ultrasound measurement of fetal thoracic circumference, lung volume, head and abdominal circumference, and femur length. We obtained Doppler blood flow velocity measures from the proximal branches of the fetal pulmonary artery. Associations between variables were studied using Pearson's correlation and multiple linear regression analyses. RESULTS Both thoracic circumference and lung volume correlated with fetal size measures, ranging from r = 0.64 between thoracic circumference and abdominal circumference, to r = 0.28 between lung volume and femur length. Adjustment for gestational age, maternal nicotine use, pre-pregnancy body mass index, and fetal sex marginally influenced the associations with abdominal circumference. The correlations of thoracic circumference and lung volume with pulmonary artery blood flow velocity measures were weak (r ≤ 0.17). CONCLUSION We found moderate to low correlation between thoracic circumference, lung volume, and fetal size at 30 GW. The closest relationship was with the abdominal circumference. We found low correlations of thoracic circumference and lung volume with pulmonary artery blood flow velocity measures.
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Affiliation(s)
- Katarina Hilde
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo
| | - Karin C Lødrup Carlsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karen Eline Stensby Bains
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Hrefna Katrín Gudmundsdóttir
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Christine Monceyron Jonassen
- Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
- Department of Chemistry, Biotechnology and Food science, Norwegian University of Life Sciences, Ås, Norway
| | - Ina Kreyberg
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Marissa LeBlanc
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Live Nordhagen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- VID Specialized University, Oslo, Norway
| | - Björn Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Maria Rehbinder
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo
- Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | | | - Håvard Ove Skjerven
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo
| | | | - Riyas Vettukattil
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo
| | - Magdalena R Vaernesbranden
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo
- Department of Gynecology and Obstetrics, Østfold Hospital Trust, Kalnes, Norway
| | - Johanna Wiik
- Department of Gynecology and Obstetrics, Østfold Hospital Trust, Kalnes, Norway
- Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Guttorm Haugen
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo
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22
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Langen I, Langesæter E, Almaas V, Letting A, Haugen G, Estensen M, Sørbye I. 62. Hypertensive pregnancy disorders: Is the prevalence higher among women with heart disease? Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Oftedal A, Bekkhus M, Haugen G, Braithwaite E, Bollerslev J, Godang K, Thorsby PM, Kaasen A. Changes in maternal cortisol, cortisol binding globulin and cortisone levels following diagnosis of fetal anomaly. Psychoneuroendocrinology 2022; 135:105574. [PMID: 34741978 DOI: 10.1016/j.psyneuen.2021.105574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 11/25/2022]
Abstract
The diagnosis of fetal anomaly can be a major stressor to the expectant mother. Current understanding of the relationship between psychological stress and cortisol in pregnancy is limited. This study examined: (1) differences in the ratio of serum cortisol to cortisol binding globulin (SC/CBG) and cortisone levels among women with and without a diagnosis of fetal anomaly, (2) the association between self-reported stress and cortisol from mid to late pregnancy, and (3) the agreement between two different techniques for analyzing cortisol: liquid chromatography-tandem mass spectrometry (LC-MS/MS) and radioimmunoassay (RIA). Thirty-six pregnant women with a diagnosis of fetal anomaly (study group) and 101 women with healthy pregnancies (comparison group) provided blood samples and completed self-report questionnaires at gestational weeks 18-24 (T1) and 30 (T2). In the comparison group, mean SC/CBG increased from 0.341 nmol/L at T1 to 0.415 at T2 (p < .001), whereas in the study group there was no change (0.342 nmol/L at T1, 0.343 at T2). There was no difference in cortisone levels between the groups at either timepoints. There was a negative association between both depression and traumatic stress at T1, and SC/CBG at T2 (p < .05). There was no association between general distress and SC/CBG. The two methods for analyzing cortisol gave similar results, but with LC-MS/MS showing a lower detection limit than RIA. Increased cortisol with advancing gestational age is expected, thus these findings indicate that under certain conditions of severe stress there may be a suppression of maternal cortisol increase from mid to late gestation. The discrepancy does not seem to be due to differences in the metabolization of cortisol, as indicated by the similar levels of cortisone. Further research is needed in order to understand the potential underlying mechanisms limiting the expression of cortisol in response to certain types of stress in pregnancy.
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Affiliation(s)
- Aurora Oftedal
- Oslo Metropolitan University, Faculty of Health Sciences, Norway.
| | - Mona Bekkhus
- Promenta Research Center, Department of Psychology, University of Oslo, Norway
| | - Guttorm Haugen
- Department of Fetal Medicine, Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway; University of Oslo, Institute of Clinical Medicine, Norway
| | | | - Jens Bollerslev
- University of Oslo, Institute of Clinical Medicine, Norway; Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Kristin Godang
- Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Per M Thorsby
- Hormone Laboratory, Department of Medical Biochemistry, Biochemical Endocrinology And Metabolism Research Group, Oslo University Hospital, Aker, Oslo, Norway
| | - Anne Kaasen
- Oslo Metropolitan University, Faculty of Health Sciences, Norway
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24
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Hoyer A, Rehbinder EM, Färdig M, Asad S, Lødrup Carlsen KC, Endre KMA, Granum B, Haugen G, Hedlin G, Monceyron Jonassen C, Katayama S, Konradsen JR, Landrø L, LeBlanc M, Mägi Olsson CA, Rudi K, Skjerven HO, Staff AC, Vettukattil R, Bradley M, Nordlund B, Söderhäll C. Filaggrin mutations in relation to skin barrier and atopic dermatitis in early infancy. Br J Dermatol 2021; 186:544-552. [PMID: 34698386 DOI: 10.1111/bjd.20831] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Loss-of-function mutations in the skin barrier gene filaggrin (FLG) increase the risk of atopic dermatitis (AD), but their role in skin barrier function, dry skin and eczema in infancy is unclear. OBJECTIVES To determine the role of FLG mutations for impaired skin barrier function, dry skin, eczema and AD at three months of age and through infancy. METHODS FLG mutations were analyzed in 1836 infants in the Scandinavian population-based PreventADALL study. Transepidermal water loss (TEWL), dry skin, eczema and AD were assessed at three, six and 12 months of age. RESULTS Filaggrin mutations were observed in 166 (9%) infants. At three months, carrying FLG mutations was not associated with impaired skin barrier function (TEWL > 11.3 g/m2 /h) or dry skin, but with eczema (OR(95%CI): 2.76 (1.81, 4.23), p < 0.001). At six months, mutation carriers had significantly higher TEWL than non-mutation carriers (mean (95%CI) 9.68 (8.69, 10.68) vs. 8.24 (7.97, 8.15), p < 0.01) and at three and six months an increased risk of dry skin on truncus (OR: 1.87 (1.25, 2.80), p = 0.002; 2.44 (1.51, 3.95), p < 0.001) or extensor limb surfaces (1.52 (1.04, 2.22), p = 0.028; 1.74 (1.17, 2.57), p = 0.005). FLG mutations were associated with eczema and AD in infancy. CONCLUSION Filaggrin mutations were not associated with impaired skin barrier function or dry skin in general at three months of age, but increased the risk for eczema, as well as for dry skin on truncus and extensors at three and six months.
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Affiliation(s)
- A Hoyer
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - E M Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway
| | - M Färdig
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - S Asad
- Dermatology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - K C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - K M A Endre
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway
| | - B Granum
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - G Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - G Hedlin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - C Monceyron Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway.,Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - S Katayama
- Folkhälsan Research Center, Helsinki, Finland.,Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden.,Stem Cells and Metabolism Research Program, University of Helsinki, Helsinki, Finland
| | - J R Konradsen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - L Landrø
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway
| | - M LeBlanc
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - C A Mägi Olsson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - K Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - H O Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - A C Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - R Vettukattil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - M Bradley
- Dermatology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - B Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - C Söderhäll
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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25
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Tedner SG, Söderhäll C, Konradsen JR, Bains KES, Borres MP, Carlsen K, Carlsen KCL, Färdig M, Gerdin SW, Gudmundsdóttir HK, Haugen G, Hedlin G, Jonassen CM, Kreyberg I, Mägi CO, Nordhagen LS, Rehbinder EM, Rudi K, Skjerven HO, Staff AC, Vettukattil R, Hage M, Nordlund B, Asarnoj A. Extract and molecular-based early infant sensitization and associated factors-A PreventADALL study. Allergy 2021; 76:2730-2739. [PMID: 33751598 DOI: 10.1111/all.14805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/15/2021] [Accepted: 01/21/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND More knowledge about sensitization patterns in early infancy, including impact of molecular allergology, is needed to help predict future allergy development more accurately. OBJECTIVE We aimed to determine the prevalence and patterns of allergic sensitization at 3 months of age, and explore possible associated factors. METHODS From the Scandinavian antenatally recruited PreventADALL mother-child cohort, we included 1110 3-month infants with available serum. Sensitization was defined as s-IgE of ≥0.1 kUA /L by Phadiatop Infant® (ThermoFisher Scientific) including birch, cat, grass, dog, milk, egg, peanut and wheat. Further ImmunoCAP analyses to ovomucoid, casein, Ara h 1-3, omega-5-gliadin were performed in food extract s-IgE-positive children. Maternal sensitization was defined as s-IgE ≥ 0.35 kUA /L to Phadiatop® (inhalant allergen mix) and/or Fx5 (food allergen mix) at 18-week pregnancy. RESULTS Overall 79 (7.3%) infants had specific sensitization, many with low s-IgE-levels (IQR 0.16-0.81 kUA /L), with 78 being sensitized to food extract allergens; 41 to egg, 27 to milk, 10 to peanut, and 25 to wheat. A total of 62/78 were further analysed, 18 (29%) had s-IgE to ovomucoid, casein, Ara h 1-3 and/or omega-5-gliadin. Eight infants (0.7%) were sensitized to inhalant allergens. Maternal sensitization to food allergens was associated with infant sensitization, odds ratio 3.64 (95% CI 1.53-8.68). CONCLUSION Already at 3 months of age, 7% were sensitized to food, mostly without detectable s-IgE to food allergen molecules, and <1% to inhalant allergens. Maternal food sensitization was associated with infants' sensitization.
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Affiliation(s)
- Sandra G. Tedner
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Jon R. Konradsen
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Karen E. S. Bains
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Magnus P. Borres
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Kai‐Håkon Carlsen
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Karin C. L. Carlsen
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Martin Färdig
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Sabina W. Gerdin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Hrefna K. Gudmundsdóttir
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Guttorm Haugen
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Christine M. Jonassen
- Genetic Unit Centre for Laboratory Medicine Østfold Hospital Trust Kalnes Norway
- Faculty of Chemistry, Biotechnology and Food Science Norwegian University of Life Sciences Ås Norway
| | - Ina Kreyberg
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Caroline‐Aleksi O. Mägi
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Live S. Nordhagen
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
- VID Specialized University Oslo Norway
| | - Eva M. Rehbinder
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
- Department of Dermatology Oslo University Hospital Oslo Norway
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science Norwegian University of Life Sciences Ås Norway
| | - Håvard O. Skjerven
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Anne C. Staff
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Riyas Vettukattil
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Marianne Hage
- Department of Medicine Solna Division of Immunology and Allergy Karolinska Institutet and University Hospital Stockholm Sweden
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Anna Asarnoj
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
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26
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Kristiansen O, Zucknick M, Reine TM, Kolset SO, Jansson T, Powell TL, Haugen G, Henriksen T, Michelsen TM. Mediators Linking Maternal Weight to Birthweight and Neonatal Fat Mass in Healthy Pregnancies. J Clin Endocrinol Metab 2021; 106:1977-1993. [PMID: 33713406 PMCID: PMC8692236 DOI: 10.1210/clinem/dgab166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Indexed: 12/16/2022]
Abstract
CONTEXT Lifestyle interventions have not efficaciously reduced complications caused by maternal weight on fetal growth, requiring insight into explanatory mediators. OBJECTIVE We hypothesized that maternal mediators, including adiponectin, leptin, insulin, and glucose, mediate effects of pregestational BMI (pBMI) and gestational weight gain (GWG) on birthweight and neonatal fat mass percentage (FM%) through placental weight and fetal mediators, including insulin levels (Ifv) and venous-arterial glucose difference (ΔGfva). Hypothesized confounders were maternal age, gestational age, and parity. METHODS A cross-sectional study of healthy mother-offspring-pairs (n = 165) applying the 4-vessel in vivo sampling method at Oslo University Hospital, Norway. We obtained pBMI, GWG, birthweight, and placental weight. FM% was available and calculated for a subcohort (n = 84). We measured circulating levels of adiponectin, leptin, glucose, and insulin and performed path analysis and traditional mediation analyses based on linear regression models. RESULTS The total effect of pBMI and GWG on newborn size was estimated to be 30 g (range, 16-45 g) birthweight and 0.17 FM% (range, 0.04-0.29 FM%) per kg∙m-2 pBMI and 31 g (range, 18-44 g) and 0.24 FM% (range, 0.10-0.37 FM%) per kg GWG. The placental weight was the main mediator, mediating 25-g birthweight and 0.11 FM% per kg∙m-2 pBMI and 25-g birthweight and 0.13 FM% per kg GWG. The maternal mediators mediated a smaller part of the effect of pBMI (3.8-g birthweight and 0.023 FM% per kg∙m-2 pBMI) but not GWG. CONCLUSION Placental weight was the main mediator linking pBMI and GWG to birthweight and FM%. The effect of pBMI, but not GWG, on birthweight and FM%, was also mediated via the maternal and fetal mediators.
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Affiliation(s)
- Oddrun Kristiansen
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, 0424Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, 0372Norway
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, 0372Norway
- Correspondence: Oddrun Kristiansen, PhD, Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, Postboks 4956 Nydalen, Oslo, 0424 Norway. ;
| | - Manuela Zucknick
- Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, 0372Norway
| | - Trine M Reine
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, 0372Norway
- Institute of Cancer Genetics and Informatics, Oslo University Hospital, Oslo, 0379Norway
| | - Svein O Kolset
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, 0372Norway
| | - Thomas Jansson
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Colorado 80045, USA
| | - Theresa L Powell
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Colorado 80045, USA
- Section of Neonatology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Colorado 80045, USA
| | - Guttorm Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, 0372Norway
- Department of Fetal Medicine, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, 0424Norway
| | - Tore Henriksen
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, 0424Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, 0372Norway
| | - Trond M Michelsen
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, 0424Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, 0372Norway
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27
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Værnesbranden MR, Wiik J, Sjøborg K, Staff AC, Carlsen KCL, Haugen G, Hedlin G, Hilde K, Nordlund B, Nystrand CF, Rangberg A, Rehbinder EM, Rudi K, Rueegg CS, Sandberg Y, Sjelmo S, Skjerven HO, Söderhäll C, Vettukattil R, Jonassen CM. Maternal human papillomavirus infections at mid-pregnancy and delivery in a Scandinavian mother-child cohort study. Int J Infect Dis 2021; 108:574-581. [PMID: 34077798 DOI: 10.1016/j.ijid.2021.05.064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Human papillomavirus (HPV) infections are common, especially during women's reproductive years, with unclear obstetrical impact. This study aimed to identify HPV prevalence at mid-gestation and delivery, type-specific persistence from mid-gestation to delivery, and risk factors for HPV infection and persistence. METHODS In 757 women from a Scandinavian prospective mother-child cohort, HPV was analyzed in first-void urine samples at mid-gestation and delivery. We used Seegene Anyplex II HPV28 PCR assay for genotyping and semi-quantifying 28 genital HPV genotypes, including 12 high-risk HPVs (HR-HPV). Socio-demographic and health data were collected through e-questionnaires. RESULTS Any-HPV genotype (any of 28 assessed) was detected in 38% of the study cohort at mid-gestation and 28% at delivery, and HR-HPVs in 24% and 16%, respectively. The most prevalent genotype was HPV16: 6% at mid-gestation and 4% at delivery. Persistence of Any-HPV genotype was 52%, as was HR-HPV genotype-specific persistence. A short pre-conception relationship with the child's father and alcohol intake during pregnancy increased HPV infection risk at both time points. Low viral load at mid-gestation was associated with clearance of HPV infections at delivery. CONCLUSION HPV prevalence was higher at mid-gestation compared with delivery, and low viral load was associated with clearance of HPV at delivery.
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Affiliation(s)
- Magdalena R Værnesbranden
- Department of Obstetrics and Gynecology, Østfold Hospital Trust, Kalnes, Norway; University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.
| | - Johanna Wiik
- Department of Obstetrics and Gynecology, Østfold Hospital Trust, Kalnes, Norway; Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Katrine Sjøborg
- Department of Obstetrics and Gynecology, Østfold Hospital Trust, Kalnes, Norway
| | - Anne Cathrine Staff
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Katarina Hilde
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Camilla F Nystrand
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Anbjørg Rangberg
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Eva Maria Rehbinder
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Department of Dermatology and Venereology, Oslo University Hospital, Oslo, Norway
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Corina Silvia Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Yvonne Sandberg
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Sigrid Sjelmo
- Department of Obstetrics and Gynecology, Østfold Hospital Trust, Kalnes, Norway
| | - Håvard O Skjerven
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Riyas Vettukattil
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Christine M Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway; Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
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28
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Nilsen M, Lokmic A, Angell IL, Lødrup Carlsen KC, Carlsen KH, Haugen G, Hedlin G, Jonassen CM, Marsland BJ, Nordlund B, Rehbinder EM, Saunders CM, Skjerven HO, Snipen L, Staff AC, Söderhäll C, Vettukattil R, Rudi K. Fecal Microbiota Nutrient Utilization Potential Suggests Mucins as Drivers for Initial Gut Colonization of Mother-Child-Shared Bacteria. Appl Environ Microbiol 2021; 87:e02201-20. [PMID: 33452029 PMCID: PMC8105027 DOI: 10.1128/aem.02201-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/04/2021] [Indexed: 01/04/2023] Open
Abstract
The nutritional drivers for mother-child sharing of bacteria and the corresponding longitudinal trajectory of the infant gut microbiota development are not yet completely settled. We therefore aimed to characterize the mother-child sharing and the inferred nutritional utilization potential for the gut microbiota from a large unselected cohort. We analyzed in depth gut microbiota in 100 mother-child pairs enrolled antenatally from the general population-based Preventing Atopic Dermatitis and Allergies in Children (PreventADALL) cohort. Fecal samples collected at gestational week 18 for mothers and at birth (meconium), 3, 6, and 12 months for infants were analyzed by reduced metagenome sequencing to determine metagenome size and taxonomic composition. The nutrient utilization potential was determined based on the Virtual Metabolic Human (VMH, www.vmh.life) database. The estimated median metagenome size was ∼150 million base pairs (bp) for mothers and ∼20 million bp at birth for the children. Longitudinal analyses revealed mother-child sharing (P < 0.05, chi-square test) from birth up to 6 months for 3 prevalent Bacteroides species (prevalence, >25% for all age groups). In a multivariate analysis of variance (ANOVA), the mother-child-shared Bacteroides were associated with vaginal delivery (1.7% explained variance, P = 0.0001). Both vaginal delivery and mother-child sharing were associated with host-derived mucins as nutrient sources. The age-related increase in metagenome size corresponded to an increased diversity in nutrient utilization, with dietary polysaccharides as the main age-related factor. Our results support host-derived mucins as potential selection means for mother-child sharing of initial colonizers, while the age-related increase in diversity was associated with dietary polysaccharides.IMPORTANCE The initial bacterial colonization of human infants is crucial for lifelong health. Understanding the factors driving this colonization will therefore be of great importance. Here, we used a novel high-taxonomic-resolution approach to deduce the nutrient utilization potential of the infant gut microbiota in a large longitudinal mother-child cohort. We found mucins as potential selection means for the initial colonization of mother-child-shared bacteria, while the transition to a more adult-like microbiota was associated with dietary polysaccharide utilization potential. This knowledge will be important for a future understanding of the importance of diet in shaping the gut microbiota composition and development during infancy.
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Affiliation(s)
- Morten Nilsen
- Faculty of Chemistry, Biotechnology, and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Asima Lokmic
- Faculty of Chemistry, Biotechnology, and Food Science, Norwegian University of Life Sciences, Ås, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Inga Leena Angell
- Faculty of Chemistry, Biotechnology, and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Karin C Lødrup Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | - Kai-Håkon Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | - Guttorm Haugen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Christine Monceyron Jonassen
- Faculty of Chemistry, Biotechnology, and Food Science, Norwegian University of Life Sciences, Ås, Norway
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Benjamin J Marsland
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Eva Maria Rehbinder
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Carina Madelen Saunders
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | - Håvard O Skjerven
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | - Lars Snipen
- Faculty of Chemistry, Biotechnology, and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Anne Cathrine Staff
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Riyas Vettukattil
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology, and Food Science, Norwegian University of Life Sciences, Ås, Norway
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29
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Carlsen OC, Gudmundsdóttir HK, Bains KES, Bertelsen R, Carlsen KC, Carlsen KH, Endre KM, Granum B, Haugen G, Hedlin G, Jonassen CM, Kreyberg I, Landrø L, Mägi CAO, Nordlund B, Nordhagen LS, Pehrson K, Saunders CM, Sjøborg K, Skjerven HO, Staff AC, Svanes C, Söderhäll C, Vettukattil R, Værnesbranden M, Wiik J, Rehbinder EM. Physical activity in pregnancy: a Norwegian-Swedish mother-child birth cohort study. AJOG Global Reports 2021; 1:100002. [PMID: 36378878 PMCID: PMC9563683 DOI: 10.1016/j.xagr.2020.100002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Physical activity during pregnancy is important for maternal and offspring health. Optimal conditions during pregnancy may help reduce the burden of noncommunicable diseases. National and international guidelines recommend at least 150 minutes of physical activity of at least moderate intensity per week. To optimize physical activity in pregnant women, it is important to identify factors associated with higher levels of physical activity. OBJECTIVE This study aimed to explore types and levels of physical activity in midpregnancy in Norway and Sweden and to identify factors associated with higher levels of physical activity. MATERIALS AND METHODS From the population-based mother-child cohort Preventing Atopic Dermatitis and Allergies in Children study recruiting 2697 women in Norway and Sweden from 2014 to 2016, we included 2349 women who answered an electronic questionnaire at enrollment in midpregnancy. Women were asked about regular physical activity in the last 2 weeks of pregnancy and afterward for types and levels of physical activity in pregnancy and before pregnancy and socioeconomic status, lifestyle, and maternal health. Logistic regression analyses were used to identify factors associated with higher levels of physical activity in pregnancy, defined as >30 minutes per session of ≥2 times per week of moderate- or high-intensity brisk walking, strength training, jogging, and bicycling. RESULTS No regular physical activity during the last 2 weeks before answering the questionnaire at midpregnancy was reported by 689 women (29%). In this study, 1787 women (76%) reported weekly strolling during pregnancy. Regular physical activity at least twice weekly in the first half of pregnancy was reported as brisk walking by 839 women (36%), bicycling by 361 women (15%), strength training by 322 women (14%), and other activities by <10% of women. Among the 1430 women with regular moderate- or high-intensity physical activity, the estimated median duration per week was 120 minutes. Higher physical activity levels were achieved in 553 women (23.5%) by brisk walking, 287 women (12.2%) by strength training, 263 women (11.2%) by bicycling, and 114 women (4.9%) by jogging. Higher physical activity levels were positively associated with regular physical activity before pregnancy, dog ownership, and atopic dermatitis and negatively associated with higher body mass index, study location in Østfold, previous pregnancy or pregnancies, non-Nordic origin, suburban living, and sick leave. CONCLUSION At midpregnancy, 29% of women were inactive, and less than 50% of women had at least 2 hours of moderate-intensity physical activity weekly. Awareness of physical activity in pregnancy should be discussed at pregnancy follow-up visits, particularly among women with higher body mass index, sick leave, previous pregnancy or pregnancies, and non-Nordic origin.
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30
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Endre KMA, Landrø L, LeBlanc M, Gjersvik P, Lødrup Carlsen KC, Haugen G, Hedlin G, Jonassen CM, Nordlund B, Rudi K, Skjerven HO, Staff AC, Söderhäll C, Vettukattil R, Rehbinder EM. Diagnosing atopic dermatitis in infancy using established diagnostic criteria: a cohort study. Br J Dermatol 2021; 186:50-58. [PMID: 33511639 DOI: 10.1111/bjd.19831] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Diagnosing atopic dermatitis (AD) in infants is challenging. OBJECTIVES To determine the incidence and persistence of eczema and AD in infants using the UK Working Party (UKWP) and Hanifin and Rajka (H&R) criteria. METHODS A cohort of 1834 infants was examined clinically at 3, 6 and 12 months of age. AD was diagnosed by UKWP (3, 6 and 12 months) and H&R (12 months) criteria. Logistic regression models were used to assess the relationship between AD and eczema. RESULTS Eczema was observed in 628 (34·2%) infants (n = 240, n = 359 and n = 329 at 3, 6 and 12 months, respectively), with AD diagnosed in 212 (33·7%) infants with any eczema and in 64/78 (82%) infants with eczema at all three visits. The odds of AD were lower with first presentation of eczema at 6 [odds ratio (OR) 0·33, 95% confidence interval (CI) 0·22-0·48] or 12 months (OR 0·49, 95% CI 0·32-0·74) than at 3 months, and higher in infants with eczema at three (OR 23·1, 95% CI 12·3-43·6) or two (OR 6·5, 95% CI 4·3-9·9) visits vs. one visit only. At 12 months, 156/329 (47·4%) fulfilled the UKWP and/or H&R criteria; 27 (8%) fulfilled the UKWP criteria only and 65 (20%) only the H&R criteria. Of the 129 infants who fulfilled the H&R criteria, 44 (34·1%) did not meet the itch criterion. CONCLUSIONS Used in combination and at multiple timepoints, the UKWP and H&R criteria for AD may be useful in clinical research but may have limited value in most other clinical settings.
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Affiliation(s)
- K M A Endre
- Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway.,University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | - L Landrø
- Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway.,University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | - M LeBlanc
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - P Gjersvik
- Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway.,University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | - K C Lødrup Carlsen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - G Haugen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - G Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women´s and Children´s Health, Karolinska Institutet, Stockholm, Sweden
| | - C M Jonassen
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway.,Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - B Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women´s and Children´s Health, Karolinska Institutet, Stockholm, Sweden
| | - K Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - H O Skjerven
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - A C Staff
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - C Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women´s and Children´s Health, Karolinska Institutet, Stockholm, Sweden
| | - R Vettukattil
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - E M Rehbinder
- Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway.,University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
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31
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Nordhagen LS, Kreyberg I, Bains KES, Carlsen K, Glavin K, Skjerven HO, Småstuen MC, Hilde K, Nordlund B, Vettukattil R, Hedlin G, Granum B, Jonassen CM, Gudmundsdóttir HK, Haugen G, Rehbinder EM, Söderhäll C, Staff AC, Lødrup Carlsen KC, Asarnoj A, Lødrup Carlsen OC, Wik Despriée Å, Dyrseth V, Endre KA, Granlund PA, Holmstrøm H, Håland G, Mägi CO, Nygaard UC, Rudi K, Saunders CM, Sjøborg KD, Skrindo I, Tedner SG, Værnesbranden MR, Wiik J. Maternal use of nicotine products and breastfeeding 3 months postpartum. Acta Paediatr 2020; 109:2594-2603. [PMID: 32274823 DOI: 10.1111/apa.15299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 03/27/2020] [Accepted: 04/01/2020] [Indexed: 01/19/2023]
Abstract
AIM We aimed to determine the prevalence of and factors associated with maternal use of nicotine products in relation to breastfeeding. METHODS Nicotine use 3 months postpartum was determined in the Scandinavian PreventADALL mother-child birth cohort study recruiting 1837 women from 2014 to 2016. Electronic questionnaires at 18 weeks pregnancy and 3 months postpartum provided information on snus use, smoking or other nicotine use, infant feeding and socio-economic factors. The risk of nicotine use in relation to breastfeeding was analysed with logistic regression. RESULTS Overall, 5.6% of women used snus (2.9%), smoked (2.7%) or both (n = 2) 3 months postpartum, while one used other nicotine products. Among the 1717 breastfeeding women, 95.1% reported no nicotine use, while 2.4% used snus, 2.5% smoked and one dual user. Compared to 3.7% nicotine use in exclusively breastfeeding women (n = 1242), the risk of nicotine use increased by partly (OR 2.26, 95% CI 1.45-3.52) and no breastfeeding (OR 4.58, 95% CI 2.57-8.21). Nicotine use before (14.5% snus, 16.4% smoking) or in pregnancy (0.2% snus, 0.4% smoking) significantly increased the risk of using nicotine during breastfeeding. CONCLUSION Few breastfeeding women used snus or smoked 3 months postpartum, with increased risk by nicotine use before or during pregnancy.
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Affiliation(s)
- Live S. Nordhagen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- VID Specialized University Oslo Norway
| | - Ina Kreyberg
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | - Karen Eline S. Bains
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | - Kai‐Håkon Carlsen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | | | - Håvard O. Skjerven
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | | | - Katarina Hilde
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Riyas Vettukattil
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Berit Granum
- Department of Environmental Health Norwegian Institute of Public Health Oslo Norway
| | - Christine M. Jonassen
- Faculty of Chemistry, Biotechnology and Food Science Norwegian University of Life Sciences Ås Norway
- Genetic Unit Centre for Laboratory Medicine Østfold Hospital Trust Kalnes Norway
| | - Hrefna K. Gudmundsdóttir
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Eva Maria Rehbinder
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Department of Dermatology Oslo University Hospital Oslo Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Anne Cathrine Staff
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Karin C. Lødrup Carlsen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
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Nilsen M, Madelen Saunders C, Leena Angell I, Arntzen MØ, Lødrup Carlsen KC, Carlsen KH, Haugen G, Heldal Hagen L, Carlsen MH, Hedlin G, Monceyron Jonassen C, Nordlund B, Maria Rehbinder E, Skjerven HO, Snipen L, Cathrine Staff A, Vettukattil R, Rudi K. Butyrate Levels in the Transition from an Infant- to an Adult-Like Gut Microbiota Correlate with Bacterial Networks Associated with Eubacterium Rectale and Ruminococcus Gnavus. Genes (Basel) 2020; 11:genes11111245. [PMID: 33105702 PMCID: PMC7690385 DOI: 10.3390/genes11111245] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/18/2020] [Accepted: 10/19/2020] [Indexed: 01/14/2023] Open
Abstract
Relatively little is known about the ecological forces shaping the gut microbiota composition during infancy. Therefore, the objective of the present study was to identify the nutrient utilization- and short-chain fatty acid (SCFA) production potential of gut microbes in infants during the first year of life. Stool samples were obtained from mothers at 18 weeks of pregnancy and from infants at birth (first stool) at 3, 6, and 12-months of age from the general population-based PreventADALL cohort. We identified the taxonomic and SCFA composition in 100 mother-child pairs. The SCFA production and substrate utilization potential of gut microbes were observed by multiomics (shotgun sequencing and proteomics) on six infants. We found a four-fold increase in relative butyrate levels from 6 to 12 months of infant age. The increase was correlated to Eubacterium rectale and its bacterial network, and Faecalibacterium prausnitzii relative abundance, while low butyrate at 12 months was correlated to Ruminococcus gnavus and its associated network of bacteria. Both E. rectale and F. prausnitzii expressed enzymes needed for butyrate production and enzymes related to dietary fiber degradation, while R. gnavus expressed mucus-, fucose, and human milk oligosaccharides (HMO)-related degradation enzymes. Therefore, we believe that the presence of E. rectale, its network, and F. prausnitzii are key bacteria in the transition from an infant- to an adult-like gut microbiota with respect to butyrate production. Our results indicate that the transition from an infant- to an adult-like gut microbiota with respect to butyrate producing bacteria, occurs between 6 and 12 months of infant age. The bacteria associated with the increased butyrate ratio/levels were E. rectale and F. prausnitzii, which potentially utilize a variety of dietary fibers based on the glycoside hydrolases (GHs) expressed. R. gnavus with a negative association to butyrate potentially utilizes mucin, fucose, and HMO components. This knowledge could have future importance in understanding how microbial metabolites can impact infant health and development.
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Affiliation(s)
- Morten Nilsen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, 1430 Ås, Norway; (I.L.A.); (M.Ø.A.); (L.H.H.); (C.M.J.); (L.S.); (K.R.)
- Correspondence: (M.N.); (C.M.S.)
| | - Carina Madelen Saunders
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, 0450 Oslo, Norway; (K.C.L.C.); (K.-H.C.); (H.O.S.); (R.V.)
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (G.H.); (E.M.R.); (A.C.S.)
- Correspondence: (M.N.); (C.M.S.)
| | - Inga Leena Angell
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, 1430 Ås, Norway; (I.L.A.); (M.Ø.A.); (L.H.H.); (C.M.J.); (L.S.); (K.R.)
| | - Magnus Ø. Arntzen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, 1430 Ås, Norway; (I.L.A.); (M.Ø.A.); (L.H.H.); (C.M.J.); (L.S.); (K.R.)
| | - Karin C. Lødrup Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, 0450 Oslo, Norway; (K.C.L.C.); (K.-H.C.); (H.O.S.); (R.V.)
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (G.H.); (E.M.R.); (A.C.S.)
| | - Kai-Håkon Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, 0450 Oslo, Norway; (K.C.L.C.); (K.-H.C.); (H.O.S.); (R.V.)
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (G.H.); (E.M.R.); (A.C.S.)
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (G.H.); (E.M.R.); (A.C.S.)
- Division of Obstetrics and Gynaecology, Oslo University Hospital, 0450 Oslo, Norway
| | - Live Heldal Hagen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, 1430 Ås, Norway; (I.L.A.); (M.Ø.A.); (L.H.H.); (C.M.J.); (L.S.); (K.R.)
| | - Monica H. Carlsen
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, 0405 Oslo, Norway;
| | - Gunilla Hedlin
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, 17176 Stockholm, Sweden; (G.H.); (B.N.)
- Department of Women’s and Children’s Health, Karolinska Institutet, 17176 Stockholm, Sweden
| | - Christine Monceyron Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, 1430 Ås, Norway; (I.L.A.); (M.Ø.A.); (L.H.H.); (C.M.J.); (L.S.); (K.R.)
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, 1714 Kalnes, Norway
| | - Björn Nordlund
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, 17176 Stockholm, Sweden; (G.H.); (B.N.)
- Department of Women’s and Children’s Health, Karolinska Institutet, 17176 Stockholm, Sweden
| | - Eva Maria Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (G.H.); (E.M.R.); (A.C.S.)
- Department of Dermatology, Oslo University Hospital, 0424 Oslo, Norway
| | - Håvard O. Skjerven
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, 0450 Oslo, Norway; (K.C.L.C.); (K.-H.C.); (H.O.S.); (R.V.)
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (G.H.); (E.M.R.); (A.C.S.)
| | - Lars Snipen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, 1430 Ås, Norway; (I.L.A.); (M.Ø.A.); (L.H.H.); (C.M.J.); (L.S.); (K.R.)
| | - Anne Cathrine Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (G.H.); (E.M.R.); (A.C.S.)
- Division of Obstetrics and Gynaecology, Oslo University Hospital, 0450 Oslo, Norway
| | - Riyas Vettukattil
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, 0450 Oslo, Norway; (K.C.L.C.); (K.-H.C.); (H.O.S.); (R.V.)
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (G.H.); (E.M.R.); (A.C.S.)
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, 1430 Ås, Norway; (I.L.A.); (M.Ø.A.); (L.H.H.); (C.M.J.); (L.S.); (K.R.)
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Olsson Mägi CA, Bjerg Bäcklund A, Lødrup Carlsen K, Almqvist C, Carlsen KH, Granum B, Haugen G, Hilde K, Lødrup Carlsen OC, Jonassen CM, Rehbinder EM, Sjøborg KD, Skjerven H, Staff AC, Vettukattil R, Söderhäll C, Nordlund B. Allergic disease and risk of stress in pregnant women: a PreventADALL study. ERJ Open Res 2020; 6:00175-2020. [PMID: 33083440 PMCID: PMC7553112 DOI: 10.1183/23120541.00175-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/23/2020] [Indexed: 11/05/2022] Open
Abstract
Background Maternal stress during pregnancy may negatively affect the health of mother and child. We therefore aimed to identify the proportion of women reporting high maternal stress in mid and late pregnancy and explore whether symptoms of maternal allergic disease are associated with perceived maternal stress in late pregnancy. Method The population-based Preventing Atopic Dermatitis and Allergy in Children (PreventADALL) study enrolled 2697 pregnant women at their 18-week routine ultrasound examination in Norway and Sweden. Information about sociodemographic factors, symptoms and doctor-diagnosed asthma, allergic rhinitis, atopic dermatitis, food allergy, and anaphylaxis and stress using the 14-item perceived stress scale (PSS) was collected at 18 weeks (mid) and 34 weeks (late) pregnancy. High stress was defined as a PSS score ≥29. Scores were analysed using multivariate logistic and linear regression. Results Among the 2164 women with complete PSS data, 17% reported asthma, 20% atopic dermatitis, 23% allergic rhinitis, 12% food allergy and 2% anaphylaxis. The proportion of women reporting high stress decreased from 15% at mid to 13% at late pregnancy (p<0.01). The adjusted odds ratio for high stress in late pregnancy was 2.25 (95% CI 1.41-3.58) for self-reported symptoms of asthma, 1.46 (95% CI 1.02-2.10) for allergic rhinitis and 2.25 (95% CI 1.32-3.82) for food allergy. A multivariate linear regression model confirmed that symptoms of asthma (β coefficient 2.11; 0.71-3.51), atopic dermatitis (β coefficient 1.76; 0.62-2.89) and food allergy (β coefficient 2.24; 0.63-3.84) were independently associated with increased PSS score. Conclusion Allergic disease symptoms in pregnancy were associated with increased stress, highlighting the importance of optimal disease control in pregnancy.
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Affiliation(s)
- Caroline-Aleksi Olsson Mägi
- Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Bjerg Bäcklund
- Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Catarina Almqvist
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Medical Epidemiology and Biostatistics, Stockholm, Sweden
| | - Kai-Håkon Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Berit Granum
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Katarina Hilde
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Oda C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Christine Monceyron Jonassen
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway.,Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Eva Maria Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Katrine D Sjøborg
- Dept of Obstetrics and Gynaecology, Østfold Hospital Trust, Kalnes, Norway
| | - Håvard Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Björn Nordlund
- Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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Abstract
BACKGROUND Prenatal screening in Norway is governed by the Biotechnology Act. According to the Act, which was adopted in 2003, prenatal screening in early pregnancy may only be offered to women with an elevated risk of having a child with chromosomal abnormalities or malformations. This type of prenatal screening is undertaken at fetal medicine centres. The purpose of this study was to identify attitudes to prenatal screening among pregnant women in the Oslo region. MATERIAL AND METHOD In the period August-November 2019, we distributed a questionnaire to all pregnant women who attended for routine ultrasound examination at Oslo University Hospital (Rikshospitalet and Ullevål hospitals) and Akershus University Hospital. Factors characterising women with different attitudes were identified. RESULTS We invited 1 212 women, 1 170 (96.5 %) of whom responded to the questionnaire survey. Of the 1 159 who answered the relevant question, 909 (78.4 %) believed that prenatal screening should be offered by the public health service to all pregnant women, and 882 of 1 026 (86 %) had paid for a private ultrasound examination early in their pregnancy. Of 690 who were aware of the non-invasive prenatal test (NIPT), 190 (27.5 %) had paid for the test. Place of birth, education, religion and parity were factors that differentiated women with different attitudes to prenatal screening. INTERPRETATION The majority of pregnant women in the Oslo region wanted to be offered early prenatal screening. Sociodemographic characteristics were a decisive factor with regard to women's attitudes to a prenatal screening service.
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Abstract
OBJECTIVE To compare Doppler blood flow velocity measures in the right and left proximal branch of the fetal pulmonary artery at 30 gestational weeks. METHODS Doppler blood flow velocity waveforms were recorded in both fetal proximal pulmonary artery branches in 62 healthy fetuses at 30 gestational weeks. Pulsatility index, peak systolic velocity, time averaged maximum velocity, time velocity integral, fetal heart rate, acceleration- and ejection time with their ratio, time of one heart cycle and time velocity integral were recorded. Paired-samples t-test was used to compare measures from the right and left pulmonary branch. RESULTS We observed significantly higher peak systolic velocity, time averaged maximum velocity, time velocity integral, acceleration time and acceleration time/ejection time ratio in the right compared to the left pulmonary artery (p < .001). Sampling angle, pulsatility index, fetal heart rate, ejection time and time of one heart cycle were similar in both pulmonary branches. CONCLUSION Our study conducted at 30 weeks gestational age found significantly different blood flow velocity waveform measures in the right and left pulmonary artery branches in contrast to previous reports of similar velocities.
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Affiliation(s)
- Katarina Hilde
- Division of Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- Division of Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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36
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Opheim GL, Moe Holme A, Blomhoff Holm M, Melbye Michelsen T, Muneer Zahid S, Paasche Roland MC, Henriksen T, Haugen G. The impact of umbilical vein blood flow and glucose concentration on blood flow distribution to the fetal liver and systemic organs in healthy pregnancies. FASEB J 2020; 34:12481-12491. [PMID: 32729124 DOI: 10.1096/fj.202000766r] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/19/2020] [Accepted: 07/07/2020] [Indexed: 12/24/2022]
Abstract
Glucose is a major energy substrate for the fetus, including liver, heart, and brain metabolism. The umbilical vein (UV) blood flow supplies the fetal liver directly from the placenta, whereas a fraction is shunted via ductus venosus (DV) to the fetal systemic circulation bypassing the fetal liver. We hypothesized UV glucose concentration to be a major regulator of the distribution of glucose supply between the fetal liver and DV, and explored the influence of maternal metabolic status on this distribution. We included 124 healthy women with normal singleton pregnancies, scheduled for elective cesarean section. UV and DV blood flow measurements were performed by Doppler ultrasound immediately before, and blood samples were obtained during surgery. UV blood flow was significantly correlated with DV blood flow, liver blood flow, and the DV shunting fraction, while UV glucose concentration was not. For normal-weight mothers, the maternal-fetal glucose gradient was positively correlated with DV shunting fraction, and negatively with liver blood flow. For the fetuses of the overweight mothers no such correlation was found. This indicates that within the normal physiological range the human fetus makes adaptations of blood flow to ensure individual needs related to the offered maternal energy supply.
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Affiliation(s)
- Gun Lisbet Opheim
- Department of Fetal Medicine, Oslo University Hospital-Rikshospitalet, Oslo, Norway.,Norwegian Advisory Unit on Women's Health, Oslo University Hospital- Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ane Moe Holme
- Department of Obstetrics, Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Maia Blomhoff Holm
- Department of Obstetrics, Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Trond Melbye Michelsen
- Norwegian Advisory Unit on Women's Health, Oslo University Hospital- Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Obstetrics, Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Saba Muneer Zahid
- Department of Fetal Medicine, Oslo University Hospital-Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marie Cecilie Paasche Roland
- Norwegian Advisory Unit on Women's Health, Oslo University Hospital- Rikshospitalet, Oslo, Norway.,Department of Obstetrics, Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Tore Henriksen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Obstetrics, Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Guttorm Haugen
- Department of Fetal Medicine, Oslo University Hospital-Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Bekkhus M, Oftedal A, Braithwaite E, Haugen G, Kaasen A. Paternal Psychological Stress After Detection of Fetal Anomaly During Pregnancy. A Prospective Longitudinal Observational Study. Front Psychol 2020; 11:1848. [PMID: 32849088 PMCID: PMC7403403 DOI: 10.3389/fpsyg.2020.01848] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 07/06/2020] [Indexed: 11/13/2022] Open
Abstract
Background and Aims Knowledge of carrying a fetus with a prenatal diagnosed anomaly may cause acute psychological stress to the parents. Most studies focus on maternal stress, yet fathers are often present at the ultrasound examinations and birth, and therefore may be affected, similarly, to the expectant mother. However, to date no existing studies have examined how detection of a fetal anomaly emotionally affects the expectant fathers throughout the pregnancy. Our aim was to longitudinally examine general health perceptions, social dysfunction and psychological distress in a subgroup of men where fetal anomaly was detected during pregnancy. Methods and Results This study is part of the SOFUS study, a prospective, longitudinal, observational study. Participants were recruited when referred for an ultrasound examination conducted by a specialist in fetal medicine at Oslo University Hospital on suspicion of fetal malformation (study group). We examined differences between the men in the study group (N = 32) and a comparison group (N = 83) on the General Health Questionnaire (GHQ), Impact of Event Scale (IES) and Edinburgh Postnatal Depression Scale (EDPS) across four time points in pregnancy. Results from repeated measured ANOVA suggests that depression decreased over time among men in both groups (η2 = 0.15, p < 0.001). This effect was stronger in the study group, and differed from the comparison group (η2 = 0.08, p < 0.001). There was also a main effect of time on IES scores, which decreased over time for both men in the study group and in the comparison group (η2 = 0.32, p < 0.001). That is, men in the study group were higher on IES initially, but this effect decreased more in the study group than in the comparison group. Men in the study group and comparison group did not differ on perceived general health (GHQ: p = 0.864). Conclusion Results suggests that detection of a fetal anomaly has implications for paternal mental health during pregnancy. Expectant fathers scored higher on EPDS and IES than the comparison group in the acute phase after detection of fetal anomaly, thus there is impetus to provide psychological support for fathers, as well as mothers, at this difficult time.
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Affiliation(s)
- Mona Bekkhus
- Department of Psychology, PROMENTA Research Center, University of Oslo, Oslo, Norway
| | - Aurora Oftedal
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Elizabeth Braithwaite
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Guttorm Haugen
- Department of Fetal Medicine Oslo, University Hospital and Institute of Clinical Medicine University of Oslo, Oslo, Norway
| | - Anne Kaasen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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38
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Skjerven HO, Rehbinder EM, Vettukattil R, LeBlanc M, Granum B, Haugen G, Hedlin G, Landrø L, Marsland BJ, Rudi K, Sjøborg KD, Söderhäll C, Staff AC, Carlsen KH, Asarnoj A, Bains KES, Carlsen OCL, Endre KMA, Granlund PA, Hermansen JU, Gudmundsdóttir HK, Hilde K, Håland G, Kreyberg I, Olsen IC, Mägi CAO, Nordhagen LS, Saunders CM, Skrindo I, Tedner SG, Værnesbranden MR, Wiik J, Jonassen CM, Nordlund B, Carlsen KCL. Skin emollient and early complementary feeding to prevent infant atopic dermatitis (PreventADALL): a factorial, multicentre, cluster-randomised trial. Lancet 2020; 395:951-961. [PMID: 32087121 DOI: 10.1016/s0140-6736(19)32983-6] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/11/2019] [Accepted: 11/21/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Skin emollients applied during early infancy could prevent atopic dermatitis, and early complementary food introduction might reduce food allergy in high-risk infants. The study aimed to determine if either regular skin emollients applied from 2 weeks of age, or early complementary feeding introduced between 12 and 16 weeks of age, reduced development of atopic dermatitis by age 12 months in the general infant population. METHODS This population-based 2×2 factorial, randomised clinical trial was done at Oslo University Hospital and Østfold Hospital Trust, Oslo, Norway; and Karolinska University Hospital, Stockholm, Sweden. Infants of women recruited antenatally at the routine ultrasound pregnancy screening at 18 weeks were cluster-randomised at birth from 2015 to 2017 to the following groups: (1) controls with no specific advice on skin care while advised to follow national guidelines on infant nutrition (no intervention group); (2) skin emollients (bath additives and facial cream; skin intervention group); (3) early complementary feeding of peanut, cow's milk, wheat, and egg (food intervention group); or (4) combined skin and food interventions (combined intervention group). Participants were randomly assigned (1:1:1:1) using computer- generated cluster randomisation based on 92 geographical living area blocks as well as eight 3-month time blocks. Carers were instructed to apply the interventions on at least 4 days per week. Atopic dermatitis by age 12 months was the primary outcome, based on clinical investigations at 3, 6 and 12 months by investigators masked to group allocation. Atopic dermatitis was assessed after completing the 12-month investigations and diagnosed if either of the UK Working Party and Hanifin and Rajka (12 months only) diagnostic criteria were fulfilled. The primary efficacy analyses was done by intention-to-treat analysis on all randomly assigned participants. Food allergy results will be reported once all investigations at age 3 years are completed in 2020. This was a study performed within ORAACLE (the Oslo Research Group of Asthma and Allergy in Childhood; the Lung and Environment). The study is registered at clinicaltrials.gov, NCT02449850. FINDINGS 2697 women were recruited between Dec 9, 2014, and Oct 31, 2016, from whom 2397 newborn infants were enrolled from April 14, 2015, to April 11, 2017. Atopic dermatitis was observed in 48 (8%) of 596 infants in the no intervention group, 64 (11%) of 575 in the skin intervention group, 58 (9%) of 642 in the food intervention group, and 31 (5%) of 583 in the combined intervention group. Neither skin emollients nor early complementary feeding reduced development of atopic dermatitis, with a risk difference of 3·1% (95% CI -0·3 to 6·5) for skin intervention and 1·0% (-2·1 to 4·1) for food intervention, in favour of control. No safety concerns with the interventions were identified. Reported skin symptoms and signs (including itching, oedema, exanthema, dry skin, and urticaria) were no more frequent in the skin, food, and combined intervention groups than in the no intervention group. INTERPRETATION Neither early skin emollients nor early complementary feeding reduced development of atopic dermatitis by age 12 months. Our study does not support the use of these interventions to prevent atopic dermatitis by 12 months of age in infants. FUNDING The study was funded by several public and private funding bodies: The Regional Health Board South East, The Norwegian Research Council, Health and Rehabilitation Norway, The Foundation for Healthcare and Allergy Research in Sweden-Vårdalstiftelsen, Swedish Asthma and Allergy Association's Research Foundation, Swedish Research Council-the Initiative for Clinical Therapy Research, The Swedish Heart-Lung Foundation, SFO-V at the Karolinska Institute, Freemason Child House Foundation in Stockholm, Swedish Research Council for Health, Working Life and Welfare-FORTE, Oslo University Hospital, the University of Oslo, and Østfold Hospital Trust.
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Affiliation(s)
- Håvard Ove Skjerven
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Eva Maria Rehbinder
- Department of Dermatology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Riyas Vettukattil
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Marissa LeBlanc
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Berit Granum
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Guttorm Haugen
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Gunilla Hedlin
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Linn Landrø
- Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - Benjamin J Marsland
- Department of Immunology and Pathology, Monash University, Melbourne, VIC, Australia; Department of Biology and Medicine, Centre Hospitalier Universitaire Vaudois-Universitu of Lausanne, Lausanne, Switzerland
| | - Knut Rudi
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | | | - Cilla Söderhäll
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anne Cathrine Staff
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kai-Håkon Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anna Asarnoj
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Karen Eline Stensby Bains
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Oda C Lødrup Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Kim M Advocaat Endre
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Peder Annæus Granlund
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Hrefna Katrín Gudmundsdóttir
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Katarina Hilde
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Geir Håland
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ina Kreyberg
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Caroline-Aleksi Olsson Mägi
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Live Solveig Nordhagen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; VID Specialized University, Oslo, Norway
| | - Carina Madelen Saunders
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingebjørg Skrindo
- Department of Otorhinolaryngology, Akershus University Hospital, Lørenskog, Norway
| | - Sandra G Tedner
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Magdalena R Værnesbranden
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Gynecology and Obstetrics, Østfold Hospital Trust, Kalnes, Norway
| | - Johanna Wiik
- Department of Gynecology and Obstetrics, Østfold Hospital Trust, Kalnes, Norway; Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Christine Monceyron Jonassen
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway; Center for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Björn Nordlund
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Karin C Lødrup Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Gustavsen A, Njerve IU, Sitras V, Haugen G, Tølløfsrud PA, Akkök ÇA. A young woman with a transfusion-related pregnancy complication. Tidsskr Nor Laegeforen 2020; 140:19-0117. [PMID: 31948214 DOI: 10.4045/tidsskr.19.0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Individuals with the K0 phenotype are extremely rare. They may develop anti-Ku antibodies, which react with all antigens of the Kell blood group system, thereby leading to haemolytic transfusion reactions and haemolytic disease of the fetus and newborn. CASE PRESENTATION A primigravida who was transfused with one unit of red blood cells due to iron deficiency anaemia developed anti-Ku antibodies. The pregnancy was closely monitored by ultrasound and antibody titres. Maternal autologous blood collection was performed twice during the last trimester as back-up in case of maternal peripartum bleeding, and a few frozen K0 red blood cell units were provided in case of severe fetal anaemia. At gestational week 36+6, labour was induced due to increasing antibody titres and high blood velocities in the fetal middle cerebral artery during systole. The woman was delivered vaginally without need for transfusion. The infant was diagnosed with haemolytic disease of the fetus and newborn and treated with phototherapy, repeated infusions of intravenous immunoglobulin and iron supplements until normalisation of haemoglobin at three months of age. INTERPRETATION Iron deficiency anaemia should be treated primarily with iron supplementation before considering blood transfusions, which pose the risk of developing alloantibodies that can cause transfusion complications and haemolytic disease of the fetus and newborn.
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Endre KM, Rehbinder EM, Carlsen KL, Carlsen KH, Gjersvik P, Hedlin G, Jonassen CM, LeBlanc M, Nordlund B, Skjerven HO, Staff AC, Söderhäll C, Vettukattil R, Landrø L, Asarnoj A, Bains KES, Carlsen MH, Lødrup Carlsen OC, Granlund PA, Granum B, Gudmundsdóttir HK, Haugen G, Kreyberg I, Mägi CAO, Nygaard UC, Rudi K, Saunders CM, Nordhagen LS, Tedner SG, Værnesbranden MR, Wiik J. Maternal and paternal atopic dermatitis and risk of atopic dermatitis during early infancy in girls and boys. The Journal of Allergy and Clinical Immunology: In Practice 2020; 8:416-418.e2. [DOI: 10.1016/j.jaip.2019.06.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/14/2019] [Accepted: 06/24/2019] [Indexed: 01/25/2023]
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Saunders CM, Rehbinder EM, Carlsen KCL, Gudbrandsgard M, Carlsen KH, Haugen G, Hedlin G, Jonassen CM, Sjøborg KD, Landrø L, Nordlund B, Rudi K, O Skjerven H, Söderhäll C, Staff AC, Vettukattil R, Carlsen MH. Food and nutrient intake and adherence to dietary recommendations during pregnancy: a Nordic mother-child population-based cohort. Food Nutr Res 2019; 63:3676. [PMID: 31920469 PMCID: PMC6939665 DOI: 10.29219/fnr.v63.3676] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/21/2022] Open
Abstract
Background A woman's food intake during pregnancy has important implications not only for herself but also for the future health and well-being of her child. Suboptimal dietary quality has been consistently reported in many high-income countries, reflecting poor adherence to dietary guidelines. Objective This study aimed to explore the intake of food and nutrients in a cohort of pregnant women in Norway and their adherence to Nordic Nutrition Recommendations (NNR) and Norwegian food-based guidelines (NFG). Design We investigated the dietary intake in 1,674 pregnant women from the mother-child birth cohort, PreventADALL, recruited at approximately 18-week gestational age. Dietary intake was assessed by an electronic validated food frequency questionnaire (PrevFFQ) in the first half of pregnancy. Results Total fat intake was within the recommended intake (RI) range in most women; however, the contribution of saturated fatty acids to the total energy intake was above RI in the majority (85.2%) of women. Carbohydrate intake was below RI in 43.9% of the women, and 69.5% exceeded the RI of salt. Intakes of fiber, vegetables, and fish were high in a large part of the population. Many women had a high probability of inadequate intakes of the following key micronutrients during pregnancy: folate (54.4%), iron (49.6%), calcium (36.2%), vitamin D (28.7%), iodine (24.4%), and selenium (41.3%). A total of 22.8% women reported an alcohol intake of >1 g/day, and 4.4% reported an alcohol intake of >10 g/day. Women with higher educational levels showed a tendency towards healthier eating habits, except for higher intakes of alcohol and coffee, compared to women with lower educational level. Discussion Excessive saturated fat intake and limited intake of many important micronutrients during pregnancy were common, potentially increasing the risk for adverse pregnancy and birth outcomes. Conclusions This study highlights the need for improved nutritional guidance to pregnant women across all educational levels.
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Affiliation(s)
- Carina Madelen Saunders
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Eva Maria Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Malén Gudbrandsgard
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Kai-Håkon Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Christine Monceyron Jonassen
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway.,Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | | | - Linn Landrø
- Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Håvard O Skjerven
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Anne Cathrine Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Monica Hauger Carlsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Kreyberg I, Hilde K, Bains KES, Carlsen KH, Granum B, Haugen G, Hedlin G, Jonassen CM, Nordhagen LS, Nordlund B, Rueegg CS, Sjøborg KD, Skjerven HO, Staff AC, Vettukattil R, Lødrup Carlsen KC. Snus in pregnancy and infant birth size: a mother-child birth cohort study. ERJ Open Res 2019; 5:00255-2019. [PMID: 31803771 PMCID: PMC6885591 DOI: 10.1183/23120541.00255-2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/07/2019] [Indexed: 11/16/2022] Open
Abstract
Rationale While recent studies show that maternal use of snus during pregnancy is increasing, the potential effects on infant birth size is less investigated, with conflicting results. Objectives We aimed to determine if maternal use of snus during pregnancy influences the infant anthropometric and proportional size measures at birth. Methods In 2313 mother–child pairs from the population-based, mother–child birth cohort PreventADALL (Preventing Atopic Dermatitis and ALLergies) in Norway and Sweden, we assessed nicotine exposure by electronic questionnaire(s) at 18 and 34 weeks of pregnancy, and anthropometric measurements at birth. Associations between snus exposure and birth size outcomes were analysed by general linear regression. Results Birthweight was not significantly different in infants exposed to snus in general, and up to 18 weeks of pregnancy in particular, when adjusting for relevant confounders including maternal age, gestational age at birth, pre-pregnancy body mass index, parity, fetal sex and maternal gestational weight gain up to 18 weeks. We found no significant effect of snus use on the other anthropometric or proportional size measures in multivariable linear regression models. Most women stopped snus use in early pregnancy. Conclusion Exposure to snus use in early pregnancy, with most women stopping when knowing about their pregnancy, was not associated with birth size. We were unable to conclude on effects of continued snus use during pregnancy because of lack of exposure in our cohort. Snus use in pregnancy, reported by 7.1% of 2313 women, was not associated with infant birth size. As most women stopped snus use by 6 weeks gestational age, it was not possible to assess potential birth size effects of persistent use during pregnancy.http://bit.ly/2IG8Vnk
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Affiliation(s)
- Ina Kreyberg
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Katarina Hilde
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Karen Eline S Bains
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Kai-Håkon Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Berit Granum
- Dept of Toxicology and Risk Assessment, Norwegian Institute of Public Health, Oslo, Norway
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Christine M Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway.,Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Live S Nordhagen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,VID Specialized University, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Corina S Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Katrine D Sjøborg
- Dept of Obstetrics and Gynaecology, Østfold Hospital Trust, Kalnes, Norway
| | - Håvard O Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne C Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
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Horne H, Holme AM, Roland MCP, Holm MB, Haugen G, Henriksen T, Michelsen TM. Maternal-fetal cholesterol transfer in human term pregnancies. Placenta 2019; 87:23-29. [PMID: 31541855 DOI: 10.1016/j.placenta.2019.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 08/16/2019] [Accepted: 09/02/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The extent to which the human term fetus utilizes cholesterol released from the placenta has remained elusive. Our aims were to estimate the net mass of cholesterol taken up by the uteroplacental unit, released by the placenta and taken up by the fetus. Thereby we aimed to explore the maternal-fetal cholesterol transfer and hypothesized that maternal levels and uteroplacental uptake were correlated to the fetal uptake of cholesterol. METHODS A cross-sectional in vivo study of 179 fasting, healthy women with uncomplicated singleton pregnancies. Blood flow in the uterine artery (n = 70) and umbilical vein (n = 125) was measured by Doppler ultrasound. Blood samples from the maternal radial artery, antecubital vein and uterine vein, and the umbilical artery and vein were obtained during cesarean section. Cholesterol was determined enzymatically. RESULTS We found a significant uteroplacental uptake (median [Q1,Q3]) of total (3.50 [-36.8,61.1]) and HDL cholesterol (6.69 [-3.78,17.9]) μmol/min, and a fetal uptake of HDL (8.07 [4.48,12.59]), LDL (5.97 [2.77,8.92]) and total cholesterol (13.2 [8.06,21.58]) μmol/min. Maternal cholesterol levels were not correlated to fetal uptake of cholesterol. There was a correlation between uteroplacental uptake of total (rho 0.35, p 0.003) and LDL cholesterol (rho 0.25, p 0.03) and the fetal uptake of LDL cholesterol from the umbilical circulation. The fetal uptake of cholesterol from HDL was higher than from LDL (p < 0.001). CONCLUSION Fetal cholesterol uptake is independent of maternal cholesterol levels, but related to the uteroplacental uptake of cholesterol from LDL. This suggests that the placenta influences maternal-fetal cholesterol transfer at term.
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Affiliation(s)
- Hildegunn Horne
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, PO BOX 4950, 0424, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, PO BOX 1072, Blindern, 0316, Oslo, Norway.
| | - Ane Moe Holme
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, PO BOX 4950, 0424, Oslo, Norway.
| | - Marie Cecilie Paasche Roland
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, PO BOX 4950, 0424, Oslo, Norway; Norwegian Advisory Unit on Women's Health, Oslo University Hospital, PO BOX 4950, 0424, Oslo, Norway.
| | - Maia Blomhoff Holm
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, PO BOX 4950, 0424, Oslo, Norway.
| | - Guttorm Haugen
- Institute of Clinical Medicine, University of Oslo, PO BOX 1072, Blindern, 0316, Oslo, Norway; Department of Fetal Medicine, Division of Obstetrics and Gynecology, Oslo University Hospital, PO BOX 4950, 0424, Oslo, Norway.
| | - Tore Henriksen
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, PO BOX 4950, 0424, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, PO BOX 1072, Blindern, 0316, Oslo, Norway.
| | - Trond Melbye Michelsen
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, PO BOX 4950, 0424, Oslo, Norway; Norwegian Advisory Unit on Women's Health, Oslo University Hospital, PO BOX 4950, 0424, Oslo, Norway.
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Abstract
Introduction During the third trimester of development, the human fetus accumulates fat, an important energy reservoir during the early postnatal period. The fetal liver, perfused by the nutrient-rich and well-oxygenated blood coming directly from the placenta, is assumed to play a central role in these processes. Earlier studies have linked fetal liver blood flow with maternal nutritional status and response to the maternal oral glucose tolerance test. Our aim was to explore the effect of a regular maternal meal on fetal liver blood flow at two timepoints during the third trimester, representing the start and towards the end of the fetal fat accretion period. We also sought to explore the influence of prepregancy body mass index on how the maternal meal affects fetal liver blood flow. Methods Using ultrasound Doppler, we examined 108 healthy women with singleton pregnancies in gestational weeks 30 and 36. At each visit, the first examination was performed with the participant in a fasting state at 08.30 a.m., followed by a standard breakfast meal of approximately 400 kcal. The examination was repeated after 105 minutes. Umbilical vein and ductus venosus blood flow was estimated from diameter and blood flow velocity measurements. Fetal liver flow was calculated as umbilical vein flow minus ductus venosus flow, and change in liver blood flow as flow after minus before the meal. The total group was divided into a normal-weight group (prepregancy body mass index 18.5–25.0 kg/m2; n = 83) and an overweight group (prepregancy body mass index >25.0 kg/m2; n = 21). Four women with prepregancy body mass index <18.5 kg/m2 were excluded from these analyses. Non-parametric statistical hypothesis tests were used for group comparisons. Results For the total group, we observed a significant increase in median (10th - 90th percentile) liver flow 28.9 (‒67.9–111.6) ml/min (p = 0.002) following the meal in week 36, but not in week 30, ‒2.63 (‒53.2–65.0) ml/min (p = 0.91). This result in turn yielded a statistically significant increase in delta liver flow from weeks 30 to 36 of 26.0 (‒107.1–146.6) ml/min (p = 0.008). The increase in postprandial liver flow was observed only in the normal-weight group in week 36. Accordingly, the delta liver flow values between the two weight groups were significantly different in week 36 (p = 0.006) but not in week 30 (p = 0.155). Among the normal-weight women, the increase in delta liver blood flow from weeks 30 to 36 was 39.3 (‒83.0–156.1) ml/min (p<0.001); in contrast, we observed no statistically significant change in the overweight group (‒44.5 (‒229.0–123.2) ml/min; p = 0.073). As a substitute for liver size, we divided the delta liver flow values by abdominal circumference and found no changes in the statistical significance results within or between the two weight groups. Conclusion In our healthy study population, we observed a statistically significant difference in liver blood flow after maternal intake of a regular meal. This effect depended on gestational age and maternal prepregancy body mass index, but apparently was independent of liver size, based on abdominal circumference as a proxy measure.
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Affiliation(s)
- Gun Lisbet Opheim
- Department of Fetal medicine, Oslo University Hospital—Rikshospitalet, Oslo, Norway
- Norwegian Advisory Unit on Women`s Health, Oslo University Hospital—Rikshospitalet, Oslo, Norway
- Institute of Clinical medicine, University of Oslo, Oslo, Norway
- * E-mail:
| | - Tore Henriksen
- Institute of Clinical medicine, University of Oslo, Oslo, Norway
- Department of Obstetrics, Oslo University Hospital—Rikshospitalet, Oslo, Norway
| | - Guttorm Haugen
- Department of Fetal medicine, Oslo University Hospital—Rikshospitalet, Oslo, Norway
- Institute of Clinical medicine, University of Oslo, Oslo, Norway
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Kreyberg I, Bains KES, Carlsen KH, Granum B, Gudmundsdóttir HK, Haugen G, Hedlin G, Hilde K, Jonassen CM, Nordhagen LS, Nordlund B, Sjøborg KD, Skjerven HO, Staff AC, Söderhäll C, Vettukatil RM, Lødrup Carlsen KC. Stopping when knowing: use of snus and nicotine during pregnancy in Scandinavia. ERJ Open Res 2019; 5:00197-2018. [PMID: 30972353 PMCID: PMC6452060 DOI: 10.1183/23120541.00197-2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 12/26/2018] [Indexed: 12/02/2022] Open
Abstract
The risk of adverse health effects in offspring due to maternal tobacco smoking during pregnancy is well documented [1], including epigenetic changes persisting in the offspring after prenatal exposure [2]. The effects of fetal exposure to nicotine from non-combustible tobacco products, such as snus or nicotine-replacement therapies (NRTs), are less clear. Use of snus leads to systemic absorption of nicotine into the maternal circulatory system, with subsequent exposure of the foetus through the placenta [3]. In young women, the use of snus increases in parallel with decreasing smoking rates but the use in pregnancy is unclear. Our aims were to determine the prevalence of snus use, smoking and other nicotine-containing product use during pregnancy, and to identify predictors for snus use in pregnancy. Prevalence was determined for 2528 women in Norway and Sweden based on the Preventing Atopic Dermatitis and ALLergies (PreventADALL) study, a population-based, mother–child birth cohort. Electronic questionnaires were completed in pregnancy week 18 and/or week 34, and potential predictors of snus use were analysed using logistic regression models. Ever use of any snus, tobacco or nicotine-containing products was reported by 35.7% of women, with similar rates of snus use (22.5%) and smoking (22.6%). Overall, 11.3% of women reported any use of nicotine-containing products in pregnancy up to 34 weeks, most often snus alone (6.5%). Most women (87.2%) stopped using snus by week 6 of pregnancy. Snus use in pregnancy was inversely associated with age and positively associated with urban living and personal or maternal history of smoking. While 11.3% of women used snus or other nicotine-containing products at some time, most stopped when recognising their pregnancy. Younger, urban living, previously smoking women were more likely to use snus in pregnancy. Of the 11.3% of women using any nicotine products in pregnancy (most often snus (6.5%)), the majority stop within pregnancy week 6. Snus use is associated with urban living, previous smoking, in utero smoking exposure of the index woman and lower age.http://ow.ly/Gyg230nmxIo
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Affiliation(s)
- Ina Kreyberg
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karen E S Bains
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Kai-H Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Berit Granum
- Dept of Toxicology and Risk Assessment, Norwegian Institute of Public Health, Oslo, Norway
| | - Hrefna K Gudmundsdóttir
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Katarina Hilde
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Christine M Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway.,Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Live S Nordhagen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,VID Specialized University, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Katrine D Sjøborg
- Dept of Obstetrics and Gynaecology, Østfold Hospital Trust, Kalnes, Norway
| | - Håvard O Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne C Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Dept of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Riyas M Vettukatil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
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46
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Michelsen TM, Holme AM, Holm MB, Roland MC, Haugen G, Powell TL, Jansson T, Henriksen T. Uteroplacental Glucose Uptake and Fetal Glucose Consumption: A Quantitative Study in Human Pregnancies. J Clin Endocrinol Metab 2019; 104:873-882. [PMID: 30339207 DOI: 10.1210/jc.2018-01154] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 10/15/2018] [Indexed: 12/16/2022]
Abstract
CONTEXT Maternal glucose levels and body mass index (BMI) are determinants of fetal overgrowth, but their relation to fetal glucose consumption is not well characterized in human pregnancy. OBJECTIVES To quantify uteroplacental glucose uptake and the allocation of glucose between the placenta and fetus and to identify factors that affect fetal glucose consumption. DESIGN Human in vivo study in term pregnancies. SETTING Oslo University Hospital, Norway. PARTICIPANTS One hundred seventy-nine healthy women with elective cesarean section. INTERVENTIONS Uterine and umbilical blood flow was determined using Doppler ultrasonography. Glucose and insulin were measured in the maternal radial artery and uterine vein and the umbilical artery and vein. In a subcohort (n = 33), GLUT1 expression was determined in isolated syncytiotrophoblast basal and microvillous plasma membranes. MAIN OUTCOME MEASURES Uteroplacental glucose uptake and placental and fetal glucose consumption quantified by the Fick principle. RESULTS Median (Q1, Q3) uteroplacental glucose uptake was 117.1 (59.1, 224.9) μmol⋅min-1, and fetal and placental glucose consumptions were 28.9 (15.4, 41.8) µmol⋅min-1⋅kg fetus-1 and 51.4 (-65.8, 185.4) µmol⋅min-1⋅kg placenta-1, respectively. Fetal glucose consumption correlated with birth weight (ρ: 0.34; P < 0.001) and maternal-fetal glucose gradient (ρ: 0.60; P < 0.001), but not with maternal BMI or uteroplacental glucose uptake. Uteroplacental glucose uptake was correlated to placental glucose consumption (ρ: 0.77; P < 0.001). Fetal and placental glucose consumptions were inversely correlated (ρ: -0.47; P < 0.001), but neither was correlated with placental GLUT1 expression. CONCLUSION These findings suggest that fetal glucose consumption is balanced against the placental needs for glucose and that placental glucose consumption is a key modulator of maternal-fetal glucose transfer in women.
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Affiliation(s)
- Trond M Michelsen
- Department of Obstetrics Rikshospitalet, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Research Unit, Sørlandet Hospital, Arendal, Norway
| | - Ane M Holme
- Department of Obstetrics Rikshospitalet, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
- University of Oslo, Oslo, Norway
| | - Maia B Holm
- Department of Obstetrics Rikshospitalet, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
- University of Oslo, Oslo, Norway
| | - Marie C Roland
- Department of Obstetrics Rikshospitalet, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
- Norwegian Advisory Unit on Women's Health, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- University of Oslo, Oslo, Norway
- Department of Fetal Medicine, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - Theresa L Powell
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Division of Neonatology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Thomas Jansson
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Tore Henriksen
- Department of Obstetrics Rikshospitalet, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
- University of Oslo, Oslo, Norway
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47
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Opheim GL, Zucknick M, Henriksen T, Haugen G. A maternal meal affects clinical Doppler parameters in the fetal middle cerebral artery. PLoS One 2018; 13:e0209990. [PMID: 30596747 PMCID: PMC6312248 DOI: 10.1371/journal.pone.0209990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 12/14/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Middle cerebral artery (MCA) and umbilical artery (UA) Doppler blood flow pulsatility indices (PIs) and MCA peak systolic velocity (PSV) are essential variables for clinically evaluating fetal well-being. Here we examined how a maternal meal influenced these Doppler blood flow velocity variables. METHODS This prospective cohort study included 89 healthy Caucasian women with normal singleton pregnancies (median age, 32 years). Measurements were performed at gestational weeks 30 and 36, representing the start and near the end of the energy-depositing period. Measured variables included the MCA-PI, UA-PI, fetal heart rate (FHR) and MCA-PSV. The cerebroplacental ratio (CPR) was calculated as the ratio of MCA-PI to UA-PI. The first examination was performed in the fasting state at 08:30 a.m. Then participants ate a standard breakfast (approximate caloric intake, 400kcal), and the examination was repeated ~105 min after the meal. RESULTS Without adjustment for FHR, fetal MCA-PI decreased after the meal at week 30 (‒0.115; p = 0.012) and week 36 (‒0.255; p < 0.001). All PI values were negatively correlated with FHR. After adjustment for FHR, MCA-PI still decreased after the meal at week 30 (‒0.087; p = 0.044) and week 36 (‒0.194; p < 0.001). The difference between the two gestational weeks was non-significant (p = 0.075). UA-PI values did not significantly change at week 30 (p = 0.253) or week 36 (p = 0.920). CPR revealed significant postprandial decreases of -0.17 at week 30 (p = 0.006) and -0.22 at week 36 (p = 0.001). Compared to fasting values, MCA-PSV was significantly higher after food intake: +3.9 cm/s at week 30 (p < 0.001) and +5.9 cm/s at week 36 (p < 0.001). CONCLUSION In gestational weeks 30 and 36, we observed a postprandial influence that was apparently specific to fetal cerebral blood flow.
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Affiliation(s)
- Gun Lisbet Opheim
- Department of Fetal Medicine, Oslo University Hospital—Rikshospitalet, Oslo, Norway
- Norwegian Advisory Unit on Woman`s Health, Oslo University Hospital—Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- * E-mail:
| | - Manuela Zucknick
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Tore Henriksen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Obstetrics, Oslo University Hospital–Rikshospitalet, Oslo, Norway
| | - Guttorm Haugen
- Department of Fetal Medicine, Oslo University Hospital—Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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48
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Lødrup Carlsen KC, Rehbinder EM, Skjerven HO, Carlsen MH, Fatnes TA, Fugelli P, Granum B, Haugen G, Hedlin G, Jonassen CM, Landrø L, Lunde J, Marsland BJ, Nordlund B, Rudi K, Sjøborg K, Söderhäll C, Cathrine Staff A, Vettukattil R, Carlsen K, Asarnoj A, Auvinen P, Stensby Bains KE, Carlsen OC, Endre KA, Granlund PA, Gudmundsdóttir HK, Haahtela T, Hilde K, Holmstrøm H, Håland G, Kreyberg I, Mägi CO, Nordhagen LS, Nygaard UC, Schinagl CM, Skrindo I, Sjelmo S, Tedner SG, Værnesbranden MR, Wiik J. Preventing Atopic Dermatitis and ALLergies in Children-the PreventADALL study. Allergy 2018; 73:2063-2070. [PMID: 29710408 DOI: 10.1111/all.13468] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Karin C. Lødrup Carlsen
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Eva Maria Rehbinder
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Dermatology Oslo University Hospital Oslo Norway
| | - Håvard O. Skjerven
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Monica Hauger Carlsen
- Department of Nutrition Institute of Basic Medical Sciences University of Oslo Oslo Norway
| | - Thea Aspelund Fatnes
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | - Pål Fugelli
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Berit Granum
- Department of Toxicology and Risk Assessment Norwegian Institute of Public Health Oslo Norway
| | - Guttorm Haugen
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women′s and Children′s Health Karolinska Institutet Stockholm Sweden
| | - Christine Monceyron Jonassen
- Genetic Unit Centre for Laboratory Medicine Østfold Hospital Trust Kalnes Norway
- Faculty of Chemistry, Biotechnology and Food Science Norwegian University of Life Sciences Ås Norway
| | - Linn Landrø
- Department of Dermatology Oslo University Hospital Oslo Norway
| | - Jon Lunde
- Department of Pediatrics Østfold Hospital Trust Kalnes Norway
| | - Benjamin J Marsland
- Service de Pneumologie Department of Biology and Medicine CHUV‐UNIL Lausanne Switzerland
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women′s and Children′s Health Karolinska Institutet Stockholm Sweden
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science Norwegian University of Life Sciences Ås Norway
| | - Katrine Sjøborg
- Department of Obstetrics and Gynaecology Østfold Hospital Trust Kalnes Norway
| | - Cilla Söderhäll
- Department of Women′s and Children′s Health Karolinska Institutet Stockholm Sweden
- Department of Biosciences and Nutrition Karolinska Institutet Stockholm Sweden
| | - Anne Cathrine Staff
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Riyas Vettukattil
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Kai‐Håkon Carlsen
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
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49
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Magelssen M, Solberg B, Supphellen M, Haugen G. Attitudes to prenatal screening among Norwegian citizens: liberality, ambivalence and sensitivity. BMC Med Ethics 2018; 19:80. [PMID: 30227857 PMCID: PMC6145324 DOI: 10.1186/s12910-018-0319-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 09/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Norway's liberal abortion law allows for abortion on social indications, yet access to screening for fetal abnormalities is restricted. Norwegian regulation of, and public discourse about prenatal screening and diagnosis has been exceptional. In this study, we wanted to investigate whether the exceptional regulation is mirrored in public attitudes. METHOD An electronic questionnaire with 11 propositions about prenatal screening and diagnosis was completed by 1617 Norwegian adults (response rate 8.5%). RESULTS A majority of respondents supports increased access to prenatal screening with ultrasound (60%) and/or full genome sequencing of fetal DNA (55%) available for all pregnant women. Significant minorities indicate, however, that a public offer of prenatal screening for all pregnant women would signal that people with Down syndrome are unwanted (46%) or could be criticized for contributing to a 'sorting society' (48%). CONCLUSIONS Results indicate deeper ambivalences and a cultural sensitivity to the ethical challenges of prenatal screening and subsequent abortions. The specific diagnosis of Down syndrome and the fear of becoming a 'sorting society' which sorts human life due to diagnoses, appear to play prominent roles in citizen deliberations. The low response rate means that a non-response bias cannot be excluded, yet reasons why results are still likely to be of value are discussed.
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Affiliation(s)
- Morten Magelssen
- Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Pb. 1130 Blindern, N-0318, Oslo, Norway.
| | - Berge Solberg
- Department of Public Health and Nursing, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Magne Supphellen
- Department of Strategy and Management, Norwegian School of Economics, Bergen, Norway
| | - Guttorm Haugen
- Department of Fetal Medicine, Division of Obstetrics and Gynecology, Oslo University Hospital and University of Oslo, Oslo, Norway
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50
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Holm MB, Kristiansen O, Holme AM, Bastani NE, Horne H, Blomhoff R, Haugen G, Henriksen T, Michelsen TM. Placental release of taurine to both the maternal and fetal circulations in human term pregnancies. Amino Acids 2018; 50:1205-1214. [PMID: 29858686 DOI: 10.1007/s00726-018-2576-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/23/2018] [Indexed: 10/14/2022]
Abstract
Taurine is regarded as an essential amino acid in utero, and fetal taurine supply is believed to rely solely on placental transfer from maternal plasma. Despite its potential role in intrauterine growth restriction and other developmental disturbances, human in vivo studies of taurine transfer between the maternal, placental, and fetal compartments are scarce. We studied placental transfer of taurine in uncomplicated human term pregnancies in vivo in a cross-sectional study of 179 mother-fetus pairs. During cesarean section, we obtained placental tissue and plasma from incoming and outgoing vessels on the maternal and fetal sides of the placenta. Taurine was measured by liquid chromatography-tandem mass spectrometry. We calculated paired arteriovenous differences, and measured placental expression of the taurine biosynthetic enzyme cysteine sulfinic acid decarboxylase (CSAD) with quantitative real-time polymerase chain reaction and western blot. We observed a fetal uptake (p < 0.001), an uteroplacental release (p < 0.001), and a negative placental consumption of taurine (p = 0.001), demonstrating a bilateral placental release to the maternal and fetal compartments. Increasing umbilical vein concentrations and fetal uptake was associated with the uteroplacental release to the maternal circulation (rs = - 0.19, p = 0.01/rs = - 0.24, p = 0.003), but not with taurine concentrations in placental tissue. CSAD-mRNA was expressed in placental tissue, suggesting a potential for placental taurine synthesis. Our observations show that the placenta has the capacity to a bilateral taurine release, indicating a fundamental role of taurine in the human placental homeostasis beyond the supply to the fetus.
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Affiliation(s)
- Maia Blomhoff Holm
- Division of Obstetrics and Gynecology, Department of Obstetrics, Oslo University Hospital, PO BOKS 4950, 0424, Oslo, Norway. .,Institute of Clinical Medicine, University of Oslo, PO BOKS 1171, Blindern, 0316, Oslo, Norway.
| | - Oddrun Kristiansen
- Division of Obstetrics and Gynecology, Department of Obstetrics, Oslo University Hospital, PO BOKS 4950, 0424, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, PO BOKS 1171, Blindern, 0316, Oslo, Norway
| | - Ane Moe Holme
- Division of Obstetrics and Gynecology, Department of Obstetrics, Oslo University Hospital, PO BOKS 4950, 0424, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, PO BOKS 1171, Blindern, 0316, Oslo, Norway
| | - Nasser Ezzatkhah Bastani
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, PO BOKS 1046, Blindern, 0316, Oslo, Norway
| | - Hildegunn Horne
- Division of Obstetrics and Gynecology, Department of Obstetrics, Oslo University Hospital, PO BOKS 4950, 0424, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, PO BOKS 1171, Blindern, 0316, Oslo, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, PO BOKS 1046, Blindern, 0316, Oslo, Norway.,Division of Cancer Medicine, Department of Clinical Service, Oslo University Hospital, PO BOKS 4950, 0424, Oslo, Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine, University of Oslo, PO BOKS 1171, Blindern, 0316, Oslo, Norway.,Division of Obstetrics and Gynecology, Department of Fetal Medicine, Oslo University Hospital, PO BOKS 4950, 0424, Oslo, Norway
| | - Tore Henriksen
- Division of Obstetrics and Gynecology, Department of Obstetrics, Oslo University Hospital, PO BOKS 4950, 0424, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, PO BOKS 1171, Blindern, 0316, Oslo, Norway
| | - Trond Melbye Michelsen
- Division of Obstetrics and Gynecology, Department of Obstetrics, Oslo University Hospital, PO BOKS 4950, 0424, Oslo, Norway.,Norwegian Advisory Unit on Women's Health, Oslo University Hospital, PO BOKS 4950, 0424, Oslo, Norway
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