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- Widbom, Andreas
(författare)
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Building a family with gamete donation : perspectives of parents and offspring
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to investigate the long-term psychosocial consequences for heterosexual couple families following oocyte donation (OD) and sperm donation (SD), in the context of the Swedish legislation. An additional aim was to explore how heterosexual couple families following SD experience the process of obtaining identifying information about the donor. Methods: As part of a prospective longitudinal study, two cross-sectional studies assessed aspects of psychosocial well-being among OD and SD families with seven-yearold children (Study I) and 13 to 17-year-old adolescents (Study II). Two qualitative interview studies explored the experiences of obtaining identifying information about the donor from the perspective of 29 adult children (Study III) and 23 parents (Study IV). Results: Study I showed that donor conception families’ psychosocial well-being is within normal levels and is not related to whether or not the parents have disclosed the use of donor conception to their seven-yearold child. Study II revealed that donor conception families’ psychosocial wellbeing is within normal levels and similar to a reference group of parents using IVF with own gametes, but that SD mothers to a significantly higher extent reported symptoms of anxiety indicating clinically relevant levels (31%) compared to OD mothers (7%) (p=.018). Study III described that searching for donor information could fill varying needs for the adult donor conceived person and that the process of obtaining donor information meant having to balance interests of different stakeholders. Study IV showed that parents’ experiences were influenced by how they perceived parenthood in the context of nature and nurture, which was related to how the parents managed the presence of the donor. Conclusions: Donor conception does not appear to be detrimental to the psychosocial well-being of families. However, both parents and their adult children face several challenges in the process of obtaining identifying information about the donor.
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| 2. |
- Widbom, Lovisa, 1994-
(författare)
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Lifestyle, biomarkers and the risk of developing inflammatory bowel disease
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic disease causing inflammation in the gut mucosa. The pathogenesis involves alteration in gut microbiota and in the intestinal barrier due to genetic factors, environmental exposure and dysregulation of the immune response. Several environmental risk factors and risk genes have been identified, but still, the pathogenesis is not fully understood. Methods: Included papers are all case-control studies based on previously collected data stored with the biobank in Umeå, Sweden. Cases are individuals that participated in the Northern Sweden Health and Disease Study (NSHDS) at least one year before developing IBD. Information was available for all cases regarding age, time and place for inclusion in NSHDS, height and weight, sex and tobacco use. Part of the cases also had available data from a detailed food-frequency questionnaire. For each available case, controls matched for age, sex and time and place were selected. Analysed factors included tobacco use, with smoking and snuff use analysed separately), cotinine (a metabolite of nicotine), iron status (including ferritin, iron, transferrin and transferrin saturation), B-vitamins and tryptophan metabolites. Results: Smoking was associated with an increased risk of developing IBD both based on questionnaire data and using cotinine as a marker for exposure. Snuff use was not associated with risk for developing IBD. A lower ferritin was associated with an increased risk of developing IBD, whereas no association was seen for other iron status analytes. When analysing iron deficiency based on ferritin and CRP, it was shown that iron deficiency was more common among men before onset of IBD, whereas no difference was seen for women. Active vitamin B6 was lower among cases compared to controls, as well as an index indicating functional B6 deficiency. Kynurenic acid and xanthurenic acid, both tryptophan metabolites with immunomodulatory properties, were lower among cases than controls. For CD only, picolinic acid was lower among cases later developing IBD.Discussion: Smoking increases the risk of developing both UC and CD. Snuff use did not increase the risk for IBD, indicating that tobacco exposure is not the reason for increased IBD risk. Low ferritin indicates an early pathological process affecting iron storage unrelated to inflammation. Changes in vitamin B6 and tryptophan metabolites might indicate early pathological processes possibly related to gut microbiota changes. To conclude, this dissertation shows that multiple differences between individuals later developing IBD and controls can be seen years before IBD diagnosis. Some of which give insight to early pathophysiology in IBD.
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