| 1. |
|
|
| 2. |
|
|
| 3. |
- Almqvist, Catarina, et al.
(författare)
-
Individual maternal and child exposure to antibiotics in hospital : a national population-based validation study
- 2015
-
Ingår i: Acta Paediatrica: Nurturing the Child. - Stockholm : Karolinska Institutet, Dept of Medical Epidemiology and Biostatistics. - 0803-5253 .- 1651-2227.
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: Exposure to antibiotics in early life may affect future health. Most antibiotics are prescribed in outpatient care, but inpatient exposure is also important. We estimated how specific diagnoses in hospitals corresponded to individual antibiotic exposure. Methods: All pregnant women and children from birth to five-years-of-age with infectious diseases and common inpatient diagnoses between July 2005 and November 2011were identified from the Swedish National Patient Register. Random samples of individuals from pre-defined groups were drawn and medical records received from the clinics were manually reviewed for antibiotics. Results: Medical records for 4,319 hospital visits were requested and 3,797 (88%) were received. A quarter (25%) of children diagnosed as premature had received antibiotics and in children from one to five-years-of-age, diagnoses associated with bacterial infections were more commonly treated with antibiotics (62.4-90.6%) than those associated with viruses (6.3-22.2%). Pregnant women who had undergone a Caesarean section were more likely to be treated with antibiotics than those who had had a vaginal delivery (40.1% versus 11.1%). Conclusions: This study defines the proportion of new mothers and young children who received individual antibiotic treatment for specific inpatient diagnoses in Sweden and provides a useful basis for future studies focusing on antibiotic use.
|
|
| 4. |
- Smew, Awad I, et al.
(författare)
-
Limited association between markers of stress during pregnancy and fetal growth in 'Born into Life' : a new prospective birth cohort
- 2018
-
Ingår i: Acta Paediatrica: Nurturing the Child. - Stockholm : Karolinska Institutet, Institute of Environmental Medicine. - 0803-5253 .- 1651-2227.
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: We aimed to investigate the associations between perceived maternal stress or salivary cortisol levels during pregnancy and birthweight. Methods: In 2010-2012, we recruited 92 women living in Stockholm, Sweden, and followed them from before conception and through pregnancy and childbirth. Their Perceived Stress Scale (PSS) scores and salivary cortisol levels were collected at 26-28 gestational weeks. Birthweight was collected from medical records. Linear regression analyses and Pearson correlations were performed between the PSS scores or cortisol levels and birthweight, respectively, adjusted for gestational age. Results: No significant associations were found between PSS scores or cortisol levels and birthweight. There was a trend towards higher salivary cortisol levels among infants with lower birthweights, and this effect was attenuated after adjusting for gestational age. Morning cortisol levels (r = -0.31, p = 0.01), the decline in cortisol levels (r = -0.26, p = 0.03) and evening cortisol levels (r = -0.21, p = 0.09) were negatively correlated with PSS scores. Conclusion: Maternal stress during pregnancy was not associated with birthweight. The inverse correlation between PSS scores and cortisol levels may indicate other mechanisms for maternal stress on child outcomes than the previous explanation of hypothalamic-pituitary-adrenal axis activity.
|
|
| 5. |
- Goksör, Emma, 1974, et al.
(författare)
-
Preschool wheeze - impact of early fish introduction and neonatal antibiotics.
- 2011
-
Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253.
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to analyse the risk factors for preschool wheeze with special reference to the early introduction of fish and early antibiotic treatment. To avoid reverse causation regarding antibiotics, we focused on the influence of broad-spectrum antibiotics given during the first week of life. Methods: Data were obtained from a prospective, longitudinal study of a cohort of children born in western Sweden where 50% of the birth cohort was randomly selected. The parents answered questionnaires at 6 and 12months and at 4.5years of age. The response rate at 4.5years was 83% (4496 of 5398 questionnaires distributed). Results: In the multivariate analysis, broad-spectrum antibiotics in the first week increased the risk of recurrent wheeze (≥3 episodes) during the last 12months at age 4.5years (adjusted OR 2.2; 95% CI 1.3-3.8) and multiple-trigger wheeze (aOR, 2.8; 1.3-6.1). The introduction of fish before the age of 9months reduced the risk of recurrent wheeze (aOR, 0.6; 0.4-0.8). Conclusion: Treatment with broad-spectrum antibiotics during the first week of life increased the risk of recurrent wheeze and multiple-trigger wheeze at preschool age. The early introduction of fish reduced the risk of recurrent wheeze.
|
|
| 6. |
- Löfqvist, Chatarina, 1964, et al.
(författare)
-
Low Postnatal Serum IGF-I levels is Associated with Bronchopulmonary Dysplasia (BPD).
- 2012
-
Ingår i: Acta paediatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 101:12, s. 1211-1216
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To characterize postnatal changes in serum IGF-I in relation to development of bronchopulmonary dysplasia (BPD) in very preterm infants. Methods: Longitudinal study of 108 infants with mean (SD) gestational age 27.2 (2.2) weeks. Weekly serum samples of IGF-I were analyzed from birth until postmenstrual age 36 weeks. Multivariate models were developed to identify independent predictors of BPD. Results: Postnatal mean IGF-I levels at postnatal day 3 to 21 were lower in infants with BPD compared to infants with no BPD (16 vs. 26 ug/L, p<0.001). Longitudinal postnatal change in IGF-I levels (IGF-I regression coefficient (β), postnatal days 3 to 21, was lower in infants with BPD compared to infants with no BPD (0.28 vs. 0.97, p=0.002) and mean IGF-I during postmenstrual age 30-33 weeks was lower in infants with BPD as compared to infants without BPD (22 vs. 29 ug/L, p<0.001). In a binomial multiple regression model lower gestational age, male gender and lower mean serum IGF-I levels during postnatal day 3-21 were the most predictive risk factors associated with BPD (r(2) =0.634, p<0.001). Conclusion: Lower IGF-I concentrations during the first weeks after very preterm birth are associated with later development of BPD. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.
|
|
| 7. |
- Wikström, Sverre, et al.
(författare)
-
Early single-channel aEEG/EEG predicts outcome in very preterm infants
- 2012
-
Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 101:7, s. 719-726
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To characterize early amplitude-integrated electroencephalogram (aEEG) and single-channel EEG (aEEG/EEG) in very preterm (VPT) infants for prediction of long-term outcome. Patients: Forty-nine infants with median (range) gestational age of 25 (2230) weeks. Methods: Amplitude-integrated electroencephalogram/EEG recorded during the first 72 h and analysed over 012, 1224, 2448 and 4872 h, for background pattern, sleepwake cycling, seizures, interburst intervals (IBI) and interburst percentage (IB%). In total, 2614 h of single-channel EEG examined for seizures. Survivors were assessed at 2 years corrected age with a neurological examination and Bayley Scales of Infant Development-II. Poor outcome was defined as death or survival with neurodevelopmental impairment. Good outcome was defined as survival without impairment. Results: Thirty infants had good outcome. Poor outcome (n = 19) was associated with depressed aEEG/EEG already during the first 12 h (p = 0.023), and with prolonged IBI and higher IB% at 24 h. Seizures were present in 43% of the infants and associated with intraventricular haemorrhages but not with outcome. Best predictors of poor outcome were burst-suppression pattern [76% correctly predicted; positive predictive value (PPV) 63%, negative predictive value (NPV) 91%], IBI > 6 sec (74% correctly predicted; PPV 67%, NPV 79%) and IB% > 55% at 24 h age (79% correctly predicted; PPV 72%, NPV 80%). In 35 infants with normal cerebral ultrasound during the first 3 days, outcome was correctly predicted in 82% by IB% (PPV 82%, NPV 83%). Conclusion: Long-term outcome can be predicted by aEEG/EEG with 7580% accuracy already at 24 postnatal hours in VPT infants, also in infants with no early indication of brain injury.
|
|
| 8. |
- Adolfsson, Peter, 1963, et al.
(författare)
-
Continuous glucose monitoring system during physical exercise in adolescents with type 1 diabetes
- 2011
-
Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 100:12, s. 1603-1609
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: Continuous glucose monitoring system (CGMS) provides detailed information on glucose fluctuations. The aim was to establish whether CGMS could be used during physical exercise and whether it detects more episodes of hypoglycaemia and hyperglycaemia than frequent blood glucose measurements. Methods: Adolescents with type 1 diabetes (12 girls and 47 boys) participated in three annual sports camps that lasted for 3-4 days and included different types of exercise: soccer, floorball + cross-country skiing and golf. During the study, blood glucose values, mean 8.7 +/- 3.3 per day, were obtained with Hemocue in parallel with the CGMS. Results: Ninety-eight per cent of the participants used the sensor at all times during the camps. Eighty-seven per cent of the sensors gave adequate signals for 24 h and 66% for 48 h. Median durations of hypoglycaemia and hyperglycaemia were 1.7 h per day and 3.8 h per day, respectively. The CGMS identified significantly more episodes of hypoglycaemia (p < 0.005) and hyperglycaemia (p < 0.005) during the day and night than frequent blood glucose tests. Conclusion: We demonstrate that, even during days that included episodic strenuous physical exercise, CGMS could provide useful information on glucose fluctuations during day and night, albeit with significant failure rates.
|
|
| 9. |
- Alwis, Gayani, et al.
(författare)
-
Normative dual energy X-ray absorptiometry data in Swedish children and adolescents.
- 2010
-
Ingår i: Acta paediatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 99, s. 1091-1099
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To present normative dual energy X-ray absorptiometry data in healthy young Swedes. Methods: Included were 710 girls and 759 boys aged 6-30 years from southern Sweden. Bone mineral content, bone mineral density, bone size, lean body and fat mass were measured by dual energy X-ray absorptiometry in total body, lumbar spine, hip, arms and legs. Results: Swedish children had similar bone mass to children in the Netherlands but higher than children in Canada and Korea. Height, weight, bone mass, bone size and lean mass increased at a constant rate from age 6 until the rapid increase in all traits at puberty. The pubertal growth spurt started earlier in girls than in boys, while the spurt in boys was larger in magnitude and occurred for a longer period. Around one-quarter of the adult total body and lumbar spine peak bone mineral content was gained during the 2 years with the fastest gain in both genders. Conclusion: This study presents normative bone mass data in Swedish children, data that are similar to that in Dutch children but higher than in Canadian and Korean children. The gain in Swedish children seems to mimic the gain seen in children in other settings.
|
|
| 10. |
- Austeng, Dordi, et al.
(författare)
-
Incidence of and risk factors for neonatal morbidity after active perinatal care : extremely preterm infants study in Sweden (EXPRESS)
- 2010
-
Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 99:7, s. 978-992
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of this study was to determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotizing enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage >= 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusion: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted.
|
|
