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- Pinborg, A, et al.
(författare)
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Why do singletons conceived after assisted reproduction technology have adverse perinatal outcome? Systematic review and meta-analysis
- 2013
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Ingår i: Human reproduction update. - : Oxford University Press (OUP). - 1460-2369 .- 1355-4786. ; 19:2, s. 87-104
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDAssisted reproduction technology (ART) is used worldwide, at increasing rates, and data show that some adverse outcomes occur more frequently than following spontaneous conception (SC). Possible explanatory factors for the well-known adverse perinatal outcome in ART singletons were evaluated.METHODSPubMed and Cochrane databases from 1982 to 2012 were searched. Studies using donor or frozen oocytes were excluded, as well as those with no control group or including <100 children. The main outcome measure was preterm birth (PTB defined as delivery <37 weeks of gestation), and a random effects model was used for meta-analyses of PTB. Other outcomes were very PTB, low-birthweight (LBW), very LBW, small for gestational age and perinatal mortality.RESULTSThe search returned 1255 articles and 65 of these met the inclusion criteria. The following were identified as predictors for PTB in singletons: SC in couples with time to pregnancy (TTP) > 1 year versus SC singletons in couples with TTP ≤ 1 year [adjusted odds ratio (AOR) 1.35, 95% confidence interval (CI) 1.22, 1.50]; IVF/ICSI versus SC singletons from subfertile couples (TTP > 1 year; AOR 1.55, 95% CI 1.30, 1.85); conception after ovulation induction and/or intrauterine insemination versus SC singletons where TTP ≤ 1 year (AOR 1.45, 95% CI 1.21, 1.74); IVF/ICSI singletons versus their non-ART singleton siblings (AOR 1.27, 95% CI 1.08, 1.49). The risk of PTB in singletons with a 'vanishing co-twin' versus from a single gestation was AOR of 1.73 (95% CI 1.54, 1.94) in the narrative data. ICSI versus IVF (AOR 0.80, 95% CI 0.69-0.93), and frozen embryo transfer versus fresh embryo transfer (AOR 0.85, 95% CI 0.76, 0.94) were associated with a lower risk of PTB.CONCLUSIONSSubfertility is a major risk factor for adverse perinatal outcome in ART singletons, however, even in the same mother an ART singleton has a poorer outcome than the non-ART sibling; hence, factors related to the hormone stimulation and/or IVF methods per se also may play a part. Further research is required into mechanisms of epigenetic modification in human embryos and the effects of cryopreservation on this, whether milder ovarian stimulation regimens can improve embryo quality and endometrial conditions, and whether longer culture times for embryos has a negative influence on the perinatal outcome.
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- Arnberg, Filip K, 1981-, et al.
(författare)
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Is Social Support Equally Important for Both Directly and Indirectly Affected Disaster Victims?
- 2011
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Ingår i: European Journal of Psychotraumatology. ; , s. 72-72
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Konferensbidrag (refereegranskat)abstract
- There has been much research on social support and its association with both general mental and physical health, and social support is an important salutogenic factor after traumatic events. Still, the magnitude of the effect of social support on posttraumatic stress (PTS) is not fully understood. In particular, the importance of social support after disasters may be contingent on exposure severity. In a survey of Swedish tourists 14 months after the tsunami in Southeast Asia (N4910), in which the survivors were exposed to few post-disaster adversities, detailed information on exposure severity allowed for an examination of the effect of the interaction between social support and exposure severity on PTS. Social support was assessed by the Crisis Support Scale and PTS by the Impact of Event Scale-Revised. Preliminary analyses will be presented, and the size and significance of the effect will be discussed.
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- Arnberg, Filip K., et al.
(författare)
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Posttraumatisk stress : Vad vi bör göra efter allvarliga händelser
- 2013
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 110:3, s. 95-98
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Tidskriftsartikel (refereegranskat)abstract
- I Sverige och Norden finns en god infrastruktur för psykosociala insatser i det tidiga skedet efter allvarliga händelser. Tillgången till senare adekvat psykologisk behandling är dock bristfällig.Akuta insatser bör ha tyngdpunkten på att främja de drabbades egen förmåga till återhämtning.Det är ineffektivt att förebygga posttraumatisk stress genom tidiga terapeutiska interventioner till alla drabbade oavsett symtomgrad.I Norden används fortfarande insatser som forskning avråder från.Traumafokuserad psykologisk behandling bör vara förstahandsval vid posttraumatiskt stressyndrom.Flera läkemedel kan lindra posttraumatisk stress, men effekten är liten.
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- Arnberg, Filip K, 1981-, et al.
(författare)
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Prevalence and Duration of PTSD in Survivors Six Years After a Natural Disaster
- 2013
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Ingår i: Journal of Anxiety Disorders. - : Elsevier BV. - 0887-6185 .- 1873-7897. ; 27:3, s. 347-352
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Tidskriftsartikel (refereegranskat)abstract
- The present study aimed to examine the prevalence of posttraumatic stress disorder (PTSD) in survivors with low levels of risk factors for PTSD. The sample included 142 adults (58% women, 54% university education, 93% employed/students/retired) on vacation in Southeast Asia during the 2004 Indian Ocean disaster. Semi-structured clinical interviews (SCID-I) were performed after 6 years including PTSD, depression, specific phobia, and alcohol abuse. The 6-year prevalence of PTSD was 11.3% and the current prevalence was 4.2%, with onset mainly within 1 month and remission within 3 years post-disaster. Suicidal ideation and comorbidity were common in PTSD cases. Lifetime prevalence of depression was 19%, specific phobia 7%, and alcohol abuse 4%. The findings suggest elevated levels of PTSD but not other disorders as compared with general population samples, but still lower levels than other disaster samples. Despite benign circumstances, however, the course and burden of PTSD were comparable to similar studies.
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- Arnberg, Filip K, 1981-, et al.
(författare)
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Properties of Swedish Posttraumatic Stress Measures after a Disaster
- 2014
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Ingår i: Journal of Anxiety Disorders. - : Elsevier BV. - 0887-6185 .- 1873-7897. ; 28:4, s. 402-409
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated the properties of Swedish versions of self-report measures of posttraumatic stress disorder (PTSD), with emphasis on the Impact of Event Scale–Revised (IES-R). Survey data from adult survivors 1, 3, and 6 years after the 2004 Indian Ocean tsunami (n = 1506) included the IES-R (from which the IES-6 was derived) and the 12-item General Health Questionnaire (GHQ-12). The PTSD Checklist (PCL) was included in one survey. A structured clinical interview was performed after 6 years (n = 142). Factor analyses of the IES-R and PCL indicated that a dysphoric-arousal model provided good fit invariant across assessments. Both measures were accurate in excluding PTSD while all measures provided poorer positive predictive values. The IES-R, but not the IES-6 and GHQ-12, evidenced stability across assessments. In conclusion, the Swedish IES-R and PCL are sound measures of chronic PTSD, and the findings illustrate important temporal aspects of PTSD assessment.
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