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Sökning: WFRF:(Skalkidou Alkistis 1977 )

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  • Cato, Karin, 1977-, et al. (författare)
  • Antenatal depressive symptoms and early initiation of breastfeeding in association with exclusive breastfeeding six weeks postpartum a longitudinal population-based study
  • 2019
  • Ingår i: BMC Pregnancy and Childbirth. - 1471-2393 .- 1471-2393. ; 19
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background</p><p>Depressive symptoms negatively impact on breastfeeding duration, whereas early breastfeeding initiation after birth enhances the chances for a longer breastfeeding period. Our aim was to investigate the interplay between depressive symptoms during pregnancy and late initiation of the first breastfeeding session and their effect on exclusive breastfeeding at six weeks postpartum.</p><p>Methods</p><p>In a longitudinal study design, web-questionnaires including demographic data, breastfeeding information and the Edinburgh Postnatal Depression Scale (EPDS) were completed by 1217 women at pregnancy weeks 17–20, 32 and/or at six weeks postpartum. A multivariable logistic regression model was fitted to estimate the effect of depressive symptoms during pregnancy and the timing of the first breastfeeding session on exclusive breastfeeding at six weeks postpartum.</p><p>Results</p><p>Exclusive breastfeeding at six weeks postpartum was reported by 77% of the women. Depressive symptoms during pregnancy (EPDS&gt; 13); (OR:1.93 [1.28–2.91]) and not accomplishing the first breastfeeding session within two hours after birth (OR: 2.61 [1.80–3.78]), were both associated with not exclusively breastfeeding at six weeks postpartum after adjusting for identified confounders. Τhe combined exposure to depressive symptoms in pregnancy and late breastfeeding initiation was associated with an almost 4-fold increased odds of not exclusive breastfeeding at six weeks postpartum.</p><p>Conclusions</p><p>Women reporting depressive symptoms during pregnancy seem to be more vulnerable to the consequences of a postponed first breastfeeding session on exclusive breastfeeding duration. Consequently, women experiencing depressive symptoms may benefit from targeted breastfeeding support during the first hours after birth.</p>
  • Liljeström, Lena, 1977-, et al. (författare)
  • Experience of fetal scalp blood sampling during labor
  • 2014
  • Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 0001-6349 .- 1600-0412. ; 93:1, s. 113-117
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Fetal scalp blood sampling (FBS) is often claimed to be painful for women in labor and difficult for obstetricians to perform. Our aim was to assess women's experience of pain during FBS and obstetricians' experience of difficulty in performing the test. At a tertiary centre in Sweden, a questionnaire with answers on a ten-point scale was completed by 51 women and by the obstetricians performing the test. Women's experience of pain had a median of 3.5. FBS was well tolerated in women who had epidural analgesia, but might be associated with pain in women without. Higher maternal body mass index and less cervical dilatation were associated with higher pain ratings. Obstetricians did not generally experience scalp sampling as difficult to perform (median score 3.0). However, the sampling procedure can be more complicated in situations with higher maternal body mass, less cervical dilatation, and a higher station of the fetal head. </p>
  • Asif, Sana, et al. (författare)
  • Severe obstetric lacerations associated with postpartum depression among women with low resilience - a Swedish birth cohort study.
  • 2020
  • Ingår i: British Journal of Obstetrics and Gynecology. - 1470-0328 .- 1471-0528.
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>OBJECTIVE:</strong> Women's levels of resilience and attitudes towards perineal lacerations vary greatly. Some women see them as part of the birthing process, while others react with anger, depressed mood or even self-harm thoughts. A previous study has reported increased risk of postpartum depressive (PPD) symptoms in women with severe perineal lacerations. The aim of this study was to assess the association between severe obstetric perineal lacerations and PPD. A secondary objective was to assess this association among women with low resilience.</p><p><strong>DESIGN:</strong> Nested cohort study.</p><p><strong>SETTING:</strong> Uppsala, Sweden.</p><p><strong>SAMPLE:</strong> Vaginally delivered women with singleton pregnancies (n = 2,990).</p><p><strong>METHODS:</strong> The main exposure was obstetric perineal lacerations. Resilience was assessed in gestational week 32 using the Swedish version of the Sense of Coherence Scale (SOC-29). A digital acyclic graph (DAG) was used to identify possible confounders and mediators. Logistic regression was used to estimate odds ratios and 95% confidence intervals. A sub-analysis was run after excluding women with normal or high resilience.</p><p><strong>MAIN OUTCOME MEASURES:</strong> Postpartum depression, assessed with the Depression Self-Reporting Scale (DSRS), completed at six weeks postpartum.</p><p><strong>RESULTS:</strong> There was no significant association between severe obstetric perineal lacerations and PPD at six weeks postpartum. However, a significant association was found between severe lacerations and PPD in women with low resilience (OR =4.8 95% CI = 1.2-20), persisting even after adjusting for confounding factors.</p><p><strong>CONCLUSION:</strong> Health care professionals might need to identify women with low resilience, as they are at increased risk for PPD after a severe perineal laceration.</p>
  • Axfors, Cathrine, et al. (författare)
  • Adult attachment's unique contribution in the prediction of postpartum depressive symptoms, beyond personality traits
  • 2017
  • Ingår i: Journal of Affective Disorders. - 0165-0327 .- 1573-2517. ; 222, s. 177-184
  • Tidskriftsartikel (refereegranskat)abstract
    • <p></p><p><strong>Background:</strong></p><p>Personality traits such as neuroticism can help identify pregnant women at risk of postpartum depressive symptoms (PPDS). However, it is unclear whether attachment style could have an additional contribution to this risk elevation. This study aimed to examine the overlap of adult attachment insecurity and neuroticism/trait anxiety as PPDS predictors, taking into account baseline depressive symptoms.</p><p><strong>Methods:</strong></p><p>A Swedish population-based sample of pregnant women reported on adult attachment and either neuroticism (n = 1063) or trait anxiety (n = 555). Depressive symptoms were assessed at baseline, and at six weeks and six months postpartum. Correlations between attachment and neuroticism/trait anxiety were calculated. Generalized linear models of PPDS tested the effect of attachment anxiety and avoidance, adjusting for neuroticism/trait anxiety and baseline depression. Logistic regression models with combined high attachment anxiety and-neuroticism/trait anxiety visualized their value as risk factors beyond antenatal depression.</p><p><strong>Results:</strong></p><p>Attachment and neuroticism/trait anxiety were highly correlated (r = .55.77). Attachment anxiety exerted a partially independent effect on PPDS at six weeks (p &lt; .05) and at six months (p &lt; .05) adjusting for neuroticism. Among antenatally non-depressed, combined high attachment anxiety and high neuroticism or trait anxiety was predictive of PPDS at both assessment points. Limitations: Low acceptance rate, exclusive use of self-reports.</p><p><strong>Conclusions:</strong></p><p>Beyond personality, attachment anxiety had a small independent effect on the risk of PPDS. Combining items of adult attachment and neuroticism/trait anxiety could prove useful in antenatal screening for high risk of PPDS.</p>
  • Axfors, Cathrine (författare)
  • Anxious personality traits in pregnant women Associations with postpartum depression, delivery complications and health care use
  • 2018
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>Anxious personality traits, including those encompassed by negative emotionality (neuroticism) and the tendency to worry about close relationships (attachment anxiety) during pregnancy were the focus of this thesis. The overall aim was to examine perinatal correlates of these characteris-tics in terms of psychiatric and obstetric health as well as antenatal care (ANC).</p><p>Papers I-II were part of a large population-based project on pregnant women in Uppsala in 2009-2012 (n=2160). Papers III-IV adjoined participants from several projects in 2005-2011, on oral contraceptive use, infertility, induced abortion, premenstrual mood disorder, and perina-tal depression (n=2819). The participants reported on the Swedish universities Scales of Per-sonality for neuroticism (papers II-IV) and the Attachment Style Questionnaire (ASQ) for attachment anxiety (papers I-II). The participants also answered the Edinburgh Postnatal De-pression Scale on depressive symptoms (paper II). In paper III, information on obstetric com-plications for primiparous women with singleton pregnancies (n=1969) was extracted from Swedish national health registers. In paper IV, ANC use was derived from medical records of obstetric low-risk women residing in Uppsala (n=1052).</p><p>The ASQ had similar psychometric properties in pregnant women (n=1631) as in previous reports (paper I). In non-depressed pregnant women (n=1431), the combination of neuroticism and attachment anxiety was the best risk indicator of postpartum depressive symptoms (paper II). Whereas high neuroticism was not related to obstetric complications (paper III), it was associated with higher use of ANC (paper IV).</p><p>Summarized, this thesis illustrates how anxious personality traits may predispose for post-partum depression and higher use of ANC in the absence of obstetric complications. Future development of these findings should be to evaluate individual and societal benefits of a greater emphasis on psychological support in ANC.</p>
  • Bannbers, Elin, 1984-, et al. (författare)
  • Prefrontal activity during response inhibition decreases over time in the postpartum period
  • 2013
  • Ingår i: Behavioural Brain Research. - 0166-4328 .- 1872-7549. ; 241:1, s. 132-138
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>The postpartum period is characterized by complex hormonal changes, but human imaging studies in the postpartum period have thus far predominantly focused on the neural correlates of maternal behavior or postpartum depression, whereas longitudinal studies on neural correlates of cognitive function across the postpartum period in healthy women are lacking. The aim of this study was to longitudinally examine response inhibition, as a measure of executive function, and its neural correlates in healthy postpartum women and non-postpartum controls. Thirteen healthy postpartum women underwent event-related functional magnetic resonance imaging while performing a Go/NoGo task. The first assessment was made within 48hours of delivery, and the second at 4-7 weeks postpartum. In addition, 13 healthy women examined twice during the menstrual cycle were included as non-postpartum controls. In postpartum women region of interest analyses revealed task-related decreased activations in the right inferior frontal gyrus, right anterior cingulate, and bilateral precentral gyri at the late postpartum assessment. Generally, postpartum women displayed lower activity during response inhibition in the bilateral inferior frontal gyri and precentral gyri compared to non-postpartum controls. No differences in response inhibition performance were found between time-points or between groups. In conclusion, this study has discovered that brain activity in prefrontal areas during a response inhibition task decreases throughout the course of the first postpartum weeks and is lower than in non-postpartum controls. Further studies on the normal adaptive brain activity changes that occur during the postpartum period are warranted.</p>
  • Bazargani, Farnaz, et al. (författare)
  • Conception by means of in vitro fertilization (IVF) is not associated with nausea and vomiting of pregnancy
  • 2020
  • Konferensbidrag (refereegranskat)abstract
    • <p>Study question:</p><p>Is there any association between mode of conception or IVF-related variables and nausea and vomiting of pregnancy (NVP)?</p><p>Summary answer:</p><p>Conception by means of IVF is not associated with NVP but the stage of the transferred embryo may affect NVP development.</p><p>What is known already:</p><p>The exact cause of NVP is unknown but risk factors including increased hormonal levels, maternal distress and anxiety disorders, also described in IVF populations, have been reported. There are only a few studies exploring NVP in IVF samples. A population-based study examining the characteristics of women who suffered from a severe form of NVP, it was reported that women with severe NVP had more often conceived through assisted reproduction techniques. So far, the relationship between NVP and IVF or different treatment related parameters in the IVF population in relation to NVP remains unclear.</p><p>Study design, size, duration:</p><p>The study is a longitudinal, matched - cohort, pilot study including 630 pregnant women with singletons without malformations, recruited during the pregnancy ultrasound in gestational week 17 (GW 17). The study was conducted between 2010-2016 at the University Hospital of Uppsala, Sweden.</p><p>Participants/materials, setting, methods:</p><p>The study population comprised 210 women with IVF conceived pregnancies and 420 age and parity matched women with spontaneous pregnancies. All participants self-reported sociodemographic and pregnancy-related information. IVF treatment data were obtained after scrutinization of the medical records. The outcome, NVP at GW 17, was divided into: 1) absence of NVP, 2) NVP not requiring medications and 3) NVP requiring medications. NVP was then studied in relation to exposure and to different IVF treatment-associated variables.</p><p>Main results and the role of chance:</p><p>The mean age of the participants was 33.7 years with 2/3 of the participants being primipara. IVF pregnant women reported more frequently comorbidities (such as hypertension, diabetes, migraine etc) (59.1% vs 49.9%), but less frequently alcohol consumption (38.4% vs 48.7%) compared to women with spontaneous pregnancies. Clinical and sociodemographic characteristics such as education, employment, smoking habits, maternal BMI, depression history, delivery fear and newborn gender, were otherwise similar between the groups. NVP with or without medications was not associated with mode of conception (<em>p</em>=0.889); 11.4% of women who conceived through IVF suffered from NVP requiring medications and 62.4% from unmedicated NVP <em>vs</em> 10.8% and 64.3% respectively of women with spontaneous pregnancies. Absence of NVP was reported by 26.2% of IVF and 24.9% of spontaneously pregnant women. However, in a subgroup analysis in the group of women who conceived through IVF, NVP was more frequently seen in the group who received cleavage stage embryos <em>vs</em> blastocysts (<em>p</em>=0.019). We could not however find any significant difference in the rate of NVP with or without medications between fresh (69.4%) or frozen/thawed embryo transfers (78.5%), nor between IVF(72.3%) and intracytoplasmic sperm injection(ICSI)(77.4%) treatments. Lastly, there was no significant difference between infertility diagnosis and NVP.</p><p>Limitations, reasons for caution:</p><p>The study had limited power to detect differences in NVP in relation to mode of conception. In addition, there was a missing rate of 30.5% in the reported embryo stage variable. Finally, the rate of blastocyst-transfers during that period was lower than otherwise expected with current statistics.</p><p>Wider implications of the findings:</p><p>It is still unclear whether IVF has an impact on the risk of NVP. However, transfer of a blastocyst may decrease the risk of developing NVP.</p>
  • Bränn, Emma, et al. (författare)
  • Inflammatory markers in late pregnancy in association with postpartum depression-A nested case-control study.
  • 2017
  • Ingår i: Psychoneuroendocrinology. - 0306-4530 .- 1873-3360. ; 79, s. 146-159
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Recent studies indicate that the immune system adaptation during pregnancy could play a significant role in the pathophysiology of perinatal depression. The aim of this study was to investigate if inflammation markers in a late pregnancy plasma sample can predict the presence of depressive symptoms at eight weeks postpartum. Blood samples from 291 pregnant women (median and IQR for days to delivery, 13 and 7-23days respectively) comprising 63 individuals with postpartum depressive symptoms, as assessed by the Edinburgh postnatal depression scale (EPDS≥12) and/or the Mini International Neuropsychiatric Interview (M.I.N.I.) and 228 controls were analyzed with an inflammation protein panel using multiplex proximity extension assay technology, comprising of 92 inflammation-associated markers. A summary inflammation variable was also calculated. Logistic regression, LASSO and Elastic net analyses were implemented. Forty markers were lower in late pregnancy among women with depressive symptoms postpartum. The difference remained statistically significant for STAM-BP (or otherwise AMSH), AXIN-1, ADA, ST1A1 and IL-10, after Bonferroni correction. The summary inflammation variable was ranked as the second best variable, following personal history of depression, in predicting depressive symptoms postpartum. The protein-level findings for STAM-BP and ST1A1 were validated in relation to methylation status of loci in the respective genes in a different population, using openly available data. This explorative approach revealed differences in late pregnancy levels of inflammation markers between women presenting with depressive symptoms postpartum and controls, previously not described in the literature. Despite the fact that the results do not support the use of a single inflammation marker in late pregnancy for assessing risk of postpartum depression, the use of STAM-BP or the novel notion of a summary inflammation variable developed in this work might be used in combination with other biological markers in the future.</p>
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