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- Dykes, K, et al.
(author)
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The importance of ultrasound of primagravidae’s thoughts about their unborn child
- 2001
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In: Journal of Reproductive and Infant Psychology. - : Informa UK Limited. - 0264-6838 .- 1469-672X. ; 19:2, s. 95-104
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Journal article (peer-reviewed)abstract
- Evaluated the importance of ultrasound to women’s thoughts about their unborn child. 10 first-time mothers (ages 22 – 33 years) with normal pregnancies were interviewed approxi¬mately 1 week before and 1 week after their first ultrasound screening. Analysis of the interviews was conducted using the techniques of grounded theory. The results show that ultrasound was of great importance for increasing the women’s awareness of bearing a child. This realization process was expressed in various categories of thoughts about the unborn child: 1. The existing fetus, 2. The coming child, 3. The woman’s life situation, 4. Parenthood and 5. Delivery. The paper examined the way in which ultrasound influences these categories of thought.
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2. |
- Hellström-Westas, Lena, et al.
(author)
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Short term effects of incubator covers on quiet sleep in stable premature infants
- 2001
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In: Acta Pædiatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 90:9, s. 1004-1008
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Journal article (peer-reviewed)abstract
- Incubator covers are increasingly being used in neonatal care as part of minimal disturbance strategies. The aim of this study was to examine possible effects of incubator covers on sleep patterns in stable premature infants. Quiet sleep (QS) can be investigated by amplitude-integrated electroencephalography (aEEG) at 32–34 weeks gestational age. In nine premature infants (gestational ages 26–32 weeks, median 29) QS periods were measured at a postconceptional age of 32–34 weeks (median 34) during two consecutive 24 h periods, one period with a padded dark cover over the incubator and one period without the cover, in a randomized order. There were no significant differences between the two 24 h periods (with incubator cover and without cover, respectively) regarding the duration of the QS periods, the percentage of QS of the total recording time (% QS) or the duration of QS intervals. However, there was a positive correlation between postnatal age in days and the mean duration of QS periods when incubator covers were used (r = 0.90, p = 0.001). When the covers were used there was a difference between the girls and the boys in the duration of QS intervals (p = 0.032); the QS intervals increased in the five girls from median (range) 63.2 (49.4–94.6) min to 77.2 (59.3–100.9) min (p = 0.043). There was no difference in the duration of QS periods between girls and boys. Conclusion: Incubator covers seem to have some short-term effects on sleep quality in premature infants but the clinical significance and possible long-term effects are not known.
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3. |
- Jensen, B, et al.
(author)
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Temperament and acceptance of dental treatment under sedation in preschool children
- 2002
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In: Acta Odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 60:4, s. 231-236
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Journal article (peer-reviewed)abstract
- The major aim of the study was to investigate whether differences concerning acceptance of dental treatment and amnesia after rectal sedation with midazolam can be explained by temperament traits in the child. Fifty children (1.5- 4.0 years), consecutively referred for dental extractions because of dental trauma or caries, were sedated with midazolam 0.3 mg kg(1) rectally. Level of sedation (state of mind) was assessed according to Wilton before and 10 min after administration of the sedative. The children's acceptance of procedures during the oral examination, the administration of the sedative, and the dental treatment were assessed according to Holst. Acceptance of an injection of local anesthesia and tooth extraction was dichotomized as satisfactory (n = 26) or unsatisfactory (n = 24). The parent assessed temperament using the Emotionality Activity Sociability (EAS) Scale of Child Temperament. Amnesia was evaluated by the parent on the following day. The relation between temperament and outcome variables was analyzed using a multiple logistic regression analysis. Children regarded as shy by the parent were at significantly greater risk of unsatisfactory acceptance of the dental treatment (P < 0.05). High scores of negative emotionality were significantly related to less amnesia (P < 0.05). We conclude that parental ratings of their child's temperament are valuable in predicting a child's acceptance of dental treatment under sedation.
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4. |
- Lindgren, Magnus, et al.
(author)
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Event-related potential findings in healthy extremely pre-term (
- 2000
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In: Child Neuropsychology. - : Informa UK Limited. - 1744-4136 .- 0929-7049. ; 6:2, s. 77-86
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Journal article (peer-reviewed)abstract
- Ten healthy extremely pre-term (EPT) children, born before gestational week 29, were tested at age 10 using mismatch negativity (MMN) and a three-tone odd-ball task; the results were then compared to age-matched full-term controls. We found no difference in MMN. By contrast, EPT children had generally shorter N1 latencies and larger P2 amplitudes, possibly indicating a more stimulus-driven response mode. However, P300 parameters, indicative of controlled attention, were unaffected.
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9. |
- Stjernqvist, Karin, et al.
(author)
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Assisterad befruktning. Uppföljning av barn som nått skolåldern
- 2001
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Reports (other academic/artistic)abstract
- Drygt 2 procent av alla svenska nyfödda barn har tillkommit med hjälp av in vitro-fertilisering, IVF, som är en medicinsk behandling för ofrivillig barnlöshet. Ägg och sperma förs samman utanför kroppen och det befruktade ägget planteras in i kvinnans livmoder. Alltsedan de första IVF-barnen föddes har frågor om såväl medicinska som sociala och psykologiska risker för barnet ställts av föräldrar, de medicinska och psykologiska professionerna och samhället. Syftet med denna studie har varit att kartlägga utveckling, beteende och självbild hos barn tillkomna efter IVF-behandling, när barnen är i skolåldern och jämföra dessa med barn som tillkommit efter vanlig konception. Samtliga 93 barn som tillkommit efter in vitro-fertilisering (IVF) under åren 1985 till 1992 och som vid uppföljningsstillfället var bosatta i Region Skåne identifierades via medicinska födelseregistret och kontaktades. Till varje barn valdes ut ålders- och könsmatchade kontrollbarn som fötts efter normal befruktning. 72 av de 93 IVF-barnen (77 procent) och lika många kontrollbarn deltog i studien. Barnen var vid undersökningstillfället, 1999–2000, 7–14 år gamla med en medelålder (m) och standarddeviation (sd) för både undersökningsgruppen och för jämförelsegruppen på 10,6 (1,7) år. Barnen testades med ett begåvningstest, beteendet kartlades genom att föräldrarna fyllde i en beteendesymtomlista. Barnens självbild kartlades med ett självsvarsfrågeformulär. Samtliga barn testades av samma psykolog vilken inte kände till barnens grupptillhörighet. 44 procent av IVF-barnen och 4 procent av kontrollbarnen var födda efter flerbörd. 30 procent av IVF-barnen och 10 procent av kontrollbarnen var för tidigt födda. IVF-barnens födelsevikt var i genomsnitt 2 795 gram jämfört med barnen i kontrollgruppen som var 3 521 gram. Det fanns ingen skillnad mellan IVF-barnens och kontrollbarnens genomsnittliga begåvning, men fler IVF-barn än kontrollbarn hade en kognitiv utveckling som låg under genomsnittet men inom normalvariationen. Andelen barn med begåvning under genomsnittet förklaras sannolikt av att fler IVF-barn är födda efter flerbörd och för tidigt. Andelen barn med begåvning över genomsnittet var lika stor i IVF- och jämförelsegruppen. Beteendeskattningsskalan visade ingen skillnad i genomsnittlig symtombelastning mellan grupperna men fler kontrollbarn än IVF-barn hade uttalade beteendeproblem. IVF-barnens självbild var god, liksom barnens i kontrollgruppen. Sammanfattningsvis visar denna studie att IVF-barns utveckling och psykiska hälsa generellt är god. Den ökade andelen IVF-barn med kognitiv utveckling inom normalvariationens nedre del förklaras av det ökade antalet tvillingfödslar och därmed ökade prematura födslar. Vid IVF-behandling bör därför risken för prematuritet minskas genom att minska andelen flerbörder.
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13. |
- Stromberg, B., et al.
(author)
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Neurological sequelae in children born after in-vitro fertilisation : A population-based study
- 2002
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In: The Lancet. - 0140-6736 .- 1474-547X. ; 359:9305, s. 461-465
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Journal article (peer-reviewed)abstract
- Background: There is an absence of population-based long-term studies on the risk of neurological sequelae in children born after in-vitro fertilisation (IVF). Our aim was to compare the frequency of such problems between IVF-born children and controls. Methods: We did a population-based retrospective cohort study in which we compared development of neurological problems in 5680 children born after IVF, with 11 360 matched controls. For 2060 twins born after IVF, a second set of controls (n=4120), all twins, were selected. We obtained data on neurological problems from the records of the Swedish habilitation centres. Findings: Children born after IVF are more likely to need habilitation services than controls (odds ratio 1.7, 95% CI 1.3-2.2). For singletons, the risk was 1.4 (1.0-2.1). The most common neurological diagnosis was cerebral palsy, for which children born after IVF had an increased risk of 3.7(2.0-6.6), and IVF singletons of 2.8 (1.3-5.8). Suspected developmental delay was increased four-fold (1.9-8.3) in children born after IVF. Twins born after IVF did not differ from control twins with respect to risk of neurological sequelae. Low-birthweight and premature infants were more likely to need habilitation than fullterm babies. Maternal age did not affect risk. Interpretation: Our study suggests that children born after IVF have an increased risk of developing neurological problems, especially cerebral palsy. These risks are largely due to the high frequency of twin pregnancies, low birthweight, and prematurity among babies born after IVF. To limit these risks, we recommend that only one embryo should be transferred during IVF.
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14. |
- Tideman, Eva, et al.
(author)
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Longitudinal follow-up of preterm children: the mother-and child relationship at 9 and 19 years of age
- 2002
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In: Journal of Reproductive and Infant Psychology. - : Informa UK Limited. - 0264-6838 .- 1469-672X. ; 20:1, s. 43-56
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Journal article (peer-reviewed)abstract
- In this longitudinal prospective study, 2 groups of children, 39 preterms and 23 fullterms, were followed up regarding the mother-child relationship at 9 and 19 years of age. Information was obtained from both the children and their mothers. A self-report scale was utilized for the assessment of the conscious attachment model, and percept-genetic tests displaying pictorial mother-child themes were utilized as a method of evaluating the uncon¬scious attachment model. A questionnaire was used to measure the degree of expressed emotion in the mother-child relationship. Percept-genetic tests show that at 9 years of age, the preterm children and their mothers differed significantly from the full-terms in their reports of the mother-child theme, and that at age 19, the preterms differed significantly from the full-terms in their perceptions of the attachment and separation themes. A greater degree of expressed emotion was found among the preterm mother-child dyads. The results indicate that preterm children may harbor emotional vulnerability regarding attachment and separation as young adults.
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15. |
- Westrup, Björn, et al.
(author)
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Evaluating neonatal developmental care
- 2003
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In: Journal of Pediatrics. - : Elsevier BV. - 1097-6833 .- 0022-3476. ; 142:5, s. 591-593
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Journal article (other academic/artistic)
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16. |
- Westrup, Björn, et al.
(author)
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Indications of improved cognitive development at one year of age among infants born very prematurely who received care based on the Newborn Individualized Developmental Care and Assessment Program (NIDCAP)
- 2002
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In: Early Human Development. - 1872-6232. ; 68:2, s. 83-91
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Journal article (peer-reviewed)abstract
- Background and Objective: Care based on the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) has been reported to exert a positive impact on the development of prematurely born infants. The aim of the present investigation was to determine the effect of such care on the 1-year development of infants born with a gestational age of less than 32 weeks. Methods: All surviving infants (11 in the NIDCAP group and 9 in the control group) were assessed employing the Bayley Scales of Infant Development at 1 year of corrected age. Results: The Mental Developmental Index (MDI) of children who had received care according to NIDCAP was higher [88 (72-114)] [median (range)] than the corresponding value for the control children [78 (50-82)] (p = 0.01). The odds ratio for being alive with an MDI > 80 was 14 (95% CI; 1.4-141.5) in favour of the intervention group. However, the Psychomotor Developmental Indices (PDI) were not significantly different [85 (61-108) and 69 (50-114), respectively] (p = 0.23). Conclusion: Our findings indicate that care based on the NIDCAP might have a positive impact on the cognitive development of infants born very prematurely. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
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17. |
- Westrup, Björn, et al.
(author)
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Neonatal individualised care in practice, a Swedish experience
- 2002
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In: Seminars in Neonatology. - : Elsevier BV. - 1084-2756. ; 7:6, s. 447-457
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Journal article (peer-reviewed)abstract
- A family-centred, developmentally supportive approach to newborn intensive care referred to as NIDCAP (Newborn Individualized Developmental Care and Assessment Programme) has caught considerable interest during recent years. In this paper we review the scientific context behind its conceptual framework and summarize our experience from 10 years of training, implementation and research. We present the short- and long-term medical and developmental outcome of our Swedish NIDCAP studies as well as attitudes of nursing staff and neonatologists. Furthermore, ethical issues and scientific obstacles concerning this concept of care are discussed.
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18. |
- Westrup, Björn, et al.
(author)
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No indication of increased quite sleep in infants receiving care based on Newborn Individulized Developmental Care and Assessment Program (NIDCAP)
- 2002
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In: Acta Pædiatrica. - 1651-2227. ; 91:3, s. 318-322
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Journal article (peer-reviewed)abstract
- It has been proposed that the developmentally supportive care of very-low-birthweight (VLBW) infants provided by the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) can improve the infants’ opportunities for rest and sleep. The aim of the present study was to determine whether quiet sleep (QS) in VLBW infants is affected by NIDCAP care. Twenty-two infants with a gestational age of <32 weeks at birth randomly received either NIDCAP (n = 11) or conventional care (n = 11). These two groups were comparable (mean (SD)) with respect to birthweight (1021 (240) vs. 913 (362) g, respectively) and gestational age (27.1 (1.7) vs. 26.4 (1.8) weeks). The infants in the NIDCAP group were cared for in a separate room by a group of specially trained nurses and subjected to weekly NIDCAP observations until they reached a postconceptional age (PCA) of 36 weeks. Quiet sleep (QS) was assessed from 24-h amplitude-integrated EEGs recorded at 32 and 36 weeks of PCA. The percentage of time [mean (SD)] spent in QS at 32 weeks of PCA was 33.5 (2.6) % for the NIDCAP group and 33.3 (6.9) % for the control infants (ns). At 36 wk, the corresponding values were 24.5 (3.2) % and 25.7 (4.7) %, respectively (ns). The number of QS periods/24 h decreased equally in both groups in association with maturation: from 24.6 (3.3) to 16.8 (1.8) and from 25.0 (5.8) to 17.5 (3.3), at 32 weeks, and 36 wk of PCA, respectively (NS). Conclusions: There were no indications of increased QS at 32 or 36 weeks of postconceptional age among VLBW infants who received care based on NIDCAP.
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19. |
- Westrup, Björn, et al.
(author)
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Preschool outcome in children born very prematurely and cared for according to the Newborn Individualized Developmental Care and Assessment Program (NIDCAP)
- 2004
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In: Acta Pædiatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 93:4, s. 498-507
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Journal article (peer-reviewed)abstract
- Aim: Care based on the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) has been reported to exert a positive impact on the development of prematurely born infants. The aim of the present investigation was to determine the effect of such care on the development at preschool age of children born with a gestational age of less than 32 wk. Methods: All surviving infants in a randomised controlled trial with infants born at a postmenstrual age less than 32 wk (11 in the NIDCAP group and 15 in the control group) were examined at 66.3 (6.0) mo corrected for prematurity [mean (SD)]. In the assessment we employed the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) for cognition, Movement Assessment Battery for Children (Movement ABC) for motor function, subtests of the NEPSY test battery for attention and distractibility, and the WHO definitions of impairment, disability and handicap. Exact binary logistic regression was employed. Results: There were no significant differences between the intervention group in Full-Scale IQ 93.4 (14.2) [mean (SD)] versus the control group 89.6 (27.2), Verbal IQ 93.6 (16.4) versus 93.7 (26.8) or Performance IQ 94.3 (14.7) versus 86.3 (24.8). In the NIDCAP group 8/13 (62%) survived without disability and for the children with conventional care this ratio was 7/19 (37%). The corresponding ratios for surviving without mental retardation were 10/13 (77%) and 11/19 (58%), and for surviving without attention deficits 10/13 (77%) and 10/19 (53%). Overall, the differences were not statistically significant, although the odds ratio for surviving with normal behaviour was statistical significant after correcting for group imbalances in gestational age, gender, growth retardation and educational level of the parents. Conclusion: Our trial suggests a positive impact by NIDCAP on behaviour at preschool age in a sample of infants born very prematurely. However, due to problems of recruitment less than half of the anticipated subjects were included in the study, which implies a low power and calls for caution in interpreting our findings. Larger trials in different cultural contexts are warranted.
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