| 1. |
|
|
| 2. |
- Gyhagen, Maria, et al.
(författare)
-
Faecal incontinence 20years after one birth: a comparison between vaginal delivery and caesarean section.
- 2014
-
Ingår i: International urogynecology journal. - : Springer Science and Business Media LLC. - 1433-3023 .- 0937-3462. ; 25:10, s. 1411-1418
-
Tidskriftsartikel (refereegranskat)abstract
- The aetiology of bowel incontinence in middle-aged women is multifactorial and the contribution of birth-related factors later in life is still poorly defined. The aim was to assess prevalence, risk factors and severity of faecal (FI, defined as the involuntary loss of faeces-solid or liquid) and anal incontinence (AI, includes FI as well as the involuntary loss of flatus) 20years after one vaginal (VD) or one caesarean section (CS).
|
|
| 3. |
- Gyhagen, Maria, et al.
(författare)
-
Prevalence and risk factors for pelvic organ prolapse 20years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery.
- 2013
-
Ingår i: BJOG : an international journal of obstetrics and gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 120:2, s. 152-60
-
Tidskriftsartikel (refereegranskat)abstract
- Please cite this paper as: Gyhagen M, Bullarbo M, Nielsen T, Milsom I. Prevalence and risk factors for pelvic organ prolapse 20years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG 2012; DOI : 10.1111/1471-0528.12020. Objective To investigate prevalence and risk factors for symptomatic pelvic organ prolapse (sPOP) and sPOP concomitant with urinary incontinence (UI) in women 20years after one vaginal delivery or one caesarean delivery. Design Registry-based national cohort study. Setting Women who returned a postal questionnaire in 2008 (response rate 65.2%). Population Singleton primiparae with a birth in 1985-88 and no further births (n=5236). Methods The SWEPOP study used validated questionnaires about sPOP and UI. Main outcome measures Prevalence rate and risk of sPOP with or without concomitant UI. Results Prevalence of sPOP was higher after vaginal delivery compared with caesarean section (14.6 versus 6.3%, odds ratio [OR] 2.55; 95% confidence interval [95% CI] 1.98-3.28) but was not increased after acute compared with elective caesarean section. Episiotomy, vacuum extraction and second-degree or more laceration were not associated with increased risk of sPOP compared with spontaneous vaginal delivery. Symptomatic POP increased 3% (OR 1.03; 95% CI 1.01-1.05) with each unit increase of current BMI and by 3% (OR 1.03; 95% CI 1.02-1.05) for each 100g increase of infant birthweight. Mothers ≤160cm who delivered a child with birthweight ≥4000g had a doubled prevalence of sPOP compared with short mothers who delivered an infant weighing <4000g (24.2 versus 13.4%, OR 2.06; 95% CI 1.19-3.55). Women with sPOP had UI and UI>10years more often than women without prolapse. Conclusion The prevalence of sPOP was doubled after vaginal delivery compared with caesarean section, two decades after one birth. Infant birthweight and current BMI were risk factors for sPOP after vaginal delivery.
|
|
| 4. |
- Gyhagen, Maria, et al.
(författare)
-
The prevalence of urinary incontinence 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery.
- 2013
-
Ingår i: BJOG : an international journal of obstetrics and gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 120:2, s. 144-151
-
Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the prevalence and risk factors for urinary incontinence (UI) 20years after one vaginal delivery or one caesarean section. Design Registry-based national cohort study. Setting Women who returned postal questionnaires (response rate 65.2%) in 2008. Population Singleton primiparae who delivered in the period 1985-1988 with no further births (n=5236). Methods The Swedish Pregnancy, Obesity and Pelvic Floor (SWEPOP) study linked Medical Birth Register (MBR) data to a questionnaire about UI. Main outcome measures Prevalence of UI and UI for more than 10years (UI>10years) were assessed 20years after childbirth. Results The prevalence of UI (40.3 versus 28.8%; OR1.67; 95%CI 1.45-1.92) and UI>10years (10.1 versus 3.9%; OR2.75; 95%CI 2.02-3.75) was higher in women after vaginal delivery than after caesarean section. There was no difference in the prevalence of UI or UI>10years after an acute caesarean section or an elective caesarean section. We found an 8% increased risk of UI per current body mass index (BMI) unit, and age at delivery increased the UI risk by 3% annually. Conclusions Two decades after one birth, vaginal delivery was associated with a 67% increased risk of UI, and UI>10years increased by 275% compared with caesarean section. Our data indicate that it is necessary to perform eight or nine caesarean sections to avoid one case of UI. Weight control is an important prophylactic measure to reduce UI. Current BMI was the most important BMI-determinant for UI, which is important, as BMI is modifiable.
|
|
| 5. |
- Hallingström, Maria, et al.
(författare)
-
Proteomic Analysis of Early Mid-Trimester Amniotic Fluid Does Not Predict Spontaneous Preterm Delivery
- 2016
-
Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:5
-
Tidskriftsartikel (refereegranskat)abstract
- Objective The aim of this study was to identify early proteomic biomarkers of spontaneous preterm delivery (PTD) in mid-trimester amniotic fluid from asymptomatic women. This is a case-cohort study. Amniotic fluid from mid-trimester genetic amniocentesis (14-19 weeks of gestation) was collected from 2008 to 2011. The analysis was conducted in 24 healthy women with subsequent spontaneous PTD (cases) and 40 randomly selected healthy women delivering at term (controls). An exploratory phase with proteomics analysis of pooled samples was followed by a verification phase with ELISA of individual case and control samples. The median (interquartile range (IQR: 25th; 75th percentiles) gestational age at delivery was 35+5 (33+6-36+6) weeks in women with spontaneous PTD and 40+0 (39+1-40+5) weeks in women who delivered at term. In the exploratory phase, the most pronounced differences were found in C-reactive protein (CRP) levels, that were approximately two-fold higher in the pooled case samples than in the pooled control samples. However, we could not verify these differences with ELISA. The median (25th; 75th IQR) CRP level was 95.2 ng/mL (64.3; 163.5) in women with spontaneous PTD and 86.0 ng/mL (51.2; 145.8) in women delivering at term (p = 0.37; t-test). Proteomic analysis with mass spectrometry of mid-trimester amniotic fluid suggests CRP as a potential marker of spontaneous preterm delivery, but this prognostic potential was not verified with ELISA.
|
|
| 6. |
- Hallingström, Maria, et al.
(författare)
-
The association between selected mid-trimester amniotic fluid candidate proteins and spontaneous preterm delivery
- 2020
-
Ingår i: Journal of Maternal-Fetal and Neonatal Medicine. - : Informa UK Limited. - 1476-7058 .- 1476-4954. ; 33:4, s. 583-592
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to explore inflammatory response and identify early potential biomarkers in mid-trimester amniotic fluid associated with subsequent spontaneous preterm delivery (PTD). Methods: A cohort study was performed at Sahlgrenska University Hospital/Östra, Gothenburg, Sweden, between 2008 and 2010. Amniotic fluid was collected from consecutive women undergoing mid-trimester transabdominal genetic amniocentesis at 14–19 gestational weeks. Clinical data and delivery outcome variables were obtained from medical records. The analysis included 19 women with spontaneous PTD and 118 women who delivered at term. A panel of 26 candidate proteins was analyzed using Luminex xMAP technology. Candidate protein concentrations were analyzed with ANCOVA and adjusted for plate effects. Results: The median gestational age at delivery was 35 + 3 weeks in women with spontaneous PTD and 40 + 0 weeks in women who delivered at term. Nominally significantly lower amniotic fluid levels of adiponectin (PTD: median 130,695 pg/mL (IQR 71,852–199,414) vs term: median 185,329 pg/mL (IQR (135,815–290,532)), granulocyte-macrophage colony stimulating factor (PTD: median 137 pg/mL (IQR 74–156) vs term: median 176 pg/mL (IQR 111–262)), and macrophage migration inhibitory factor (PTD: median 3025 pg/mL (IQR 1885–3891) vs term: median 3400 pg/mL (IQR 2181–5231)) were observed in the spontaneous PTD group, compared with the term delivery group, after adjusting for plate effects. No significant differences remained after Bonferroni correction for multiple comparisons. Conclusions: Our results are important in the process of determining the etiology behind spontaneous PTD but due to the non-significance after Bonferroni correction, the results should be interpreted with caution. Further analyses of larger sample size will be required to determine whether these results are cogent and to examine whether microbial invasion of the amniotic cavity or intra-amniotic inflammation occurs in asymptomatic women in the mid-trimester with subsequent spontaneous PTD.
|
|
| 7. |
- Armstrong, P. M., et al.
(författare)
-
Prevalence of Vitamin D Insufficiency and Its Determinants among Women Undergoing In Vitro Fertilization Treatment for Infertility in Sweden
- 2023
-
Ingår i: Nutrients. - 2072-6643. ; 15:12
-
Tidskriftsartikel (refereegranskat)abstract
- There is a lack of research on women with infertility in the northern latitudes, where vitamin D insufficiency is high. Therefore, this study aimed to assess the prevalence and determinants of vitamin D insufficiency (serum 25(OH)D concentration < 50 nmol/L) among women undergoing in vitro fertilization (IVF) treatment. Thus, 265 women scheduled for IVF/intracytoplasmic sperm injection (ICSI) between September 2020 and August 2021 at Sahlgrenska University Hospital in Gothenburg, Sweden, were included. Data on serum 25(OH)D concentration, vitamin D intake, and sun exposure were collected via questionnaires and blood samples. Approximately 27% of the women had 25(OH)D insufficiency, which was associated with longer infertility duration. The likelihood of insufficiency was higher among women from non-Nordic European countries (OR 2.92, 95% CI 1.03-8.26, adjusted p = 0.043), the Middle East (OR 9.90, 95% CI 3.32-29.41, adjusted p < 0.001), and Asia (OR 5.49, 95% CI 1.30-23.25, adjusted p = 0.020) than among women from Nordic countries. Women who did not use vitamin D supplements were more likely to have insufficiency compared with supplement users (OR 3.32, 95% CI 1.55-7.10, adjusted p = 0.002), and those who avoided sun exposure had higher odds of insufficiency compared to those who stayed "in the sun all the time" (OR 3.24, 95% CI 1.22-8.62, adjusted p = 0.018). Women with infertility in northern latitudes and those from non-Nordic countries who avoid sun exposure and do not take vitamin supplements have a higher prevalence of 25(OH)D insufficiency and longer infertility duration.
|
|
| 8. |
- Augustin, Hanna, et al.
(författare)
-
Late Pregnancy Vitamin D Deficiency is Associated with Doubled Odds of Birth Asphyxia and Emergency Caesarean Section: A Prospective Cohort Study
- 2020
-
Ingår i: Maternal and Child Health Journal. - : Springer Science and Business Media LLC. - 1092-7875 .- 1573-6628. ; 24, s. 1412-1418
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this prospective cohort study was to investigate the associations between maternal vitamin D status in late pregnancy and emergency caesarean section (EMCS) and birth asphyxia, in a population based sample of women in Sweden. Methods Pregnant women were recruited at the antenatal care in Sweden and 1832 women were included after exclusion of miscarriages, terminated pregnancies and missing data on vitamin D status. Mode of delivery was retrieved from medical records. EMCS was defined as caesarean section after onset of labour. Birth asphyxia was defined as either 5 min Apgar score < 7 or arterial umbilical cord pH < 7.1. Serum was sampled in the third trimester of pregnancy (T3) and 25-hydroxyvitamin D (25OHD) was analysed by liquid chromatography tandem mass spectrometry. Vitamin D deficiency was defined as 25OHD < 30 nmol/L, and associations were studied using logistic regression analysis and expressed as adjusted odds ratios (AOR). Results In total, 141 (7.7%) women had an EMCS and 58 (3.2%) children were born with birth asphyxia. Vitamin D deficiency was only associated with higher odds of EMCS in women without epidural anaesthesia (AOR = 2.01, p = 0.044). Vitamin D deficiency was also associated with higher odds of birth asphyxia (AOR = 2.22, p = 0.044). Conclusions for Practice In this Swedish prospective population-based cohort study, vitamin D deficiency in late pregnancy was associated with doubled odds of birth asphyxia and with EMCS in deliveries not aided by epidural anaesthesia. Prevention of vitamin D deficiency among pregnant women may reduce the incidence of EMCS and birth asphyxia. The mechanism behind the findings require further investigation.
|
|
| 9. |
- Bullarbo, Maria, 1958, et al.
(författare)
-
Diastolic blood pressure increase is a risk indicator for pre-eclampsia.
- 2015
-
Ingår i: Archives of gynecology and obstetrics. - : Springer Science and Business Media LLC. - 1432-0711 .- 0932-0067. ; 291:4, s. 819-823
-
Tidskriftsartikel (refereegranskat)abstract
- A previous study demonstrated that the increase in diastolic blood pressure during pregnancy was reduced by supplementation with magnesium. The present study was undertaken to explore if increases in diastolic blood pressure could be useful for early identification of pre-eclampsia.
|
|
| 10. |
- Bullarbo, Maria, 1958, et al.
(författare)
-
Isosorbide mononitrate induces increased cervical expression of cyclooxygenase-2, but not of cyclooxygenase-1, at term
- 2007
-
Ingår i: Eur J Obstet Gynecol Reprod Biol. ; 130:2, s. 160-4
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Prostaglandin and nitric oxide (NO) are both known to be involved in cervical ripening at term. The aim of the study was to investigate if NO has an effect on cervical expression of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), the two main isoenzymes involved in prostaglandin synthesis, and to localize these enzymes within the cervix. STUDY DESIGN: Women with an unripe cervix scheduled for elective caesarean section at term were randomly selected to receive vaginally either the NO donor isosorbide mononitrate (IMN) or placebo 4h before surgery. At the operating theatre, cervical tissue specimens were obtained for immunoblotting and immunohistochemistry. RESULTS: Increased expression of COX-2 was found in specimens exposed to IMN compared to specimens obtained from women in the placebo group. There was no difference in the expression of COX-1. Immunohistochemistry revealed similar localization of the two enzymes in treated and untreated women. CONCLUSIONS: Vaginal administration of IMN induces increased cervical expression of COX-2, but not of COX-1. This pathway may be of importance in the process of cervical ripening at term.
|
|
