Anna-karin Bonamy - Academia.edu (original) (raw)

Papers by Anna-karin Bonamy

Research paper thumbnail of Virtual colleagues, virtually colleagues--physicians' use of Twitter: a population-based observational study

BMJ Open, 2013

To investigate potential violations of patient confidentiality or other breaches of medical ethic... more To investigate potential violations of patient confidentiality or other breaches of medical ethics committed by physicians and medical students active on the social networking site Twitter.

Research paper thumbnail of Perinatal Risk Factors for Ischemic Heart Disease Disentangling the Roles of Birth Weight and Preterm Birth

Research paper thumbnail of Perinatal Risk Factors for Diabetes in Later Life

Research paper thumbnail of Early Provision of Mother's Own Milk and Other Predictors of Successful Breast Milk Feeding after Very Preterm Birth: A Regional Observational Study

Journal of human lactation : official journal of International Lactation Consultant Association, Jan 15, 2015

Breast milk is associated with a lower risk of neonatal morbidity in very preterm infants. Despit... more Breast milk is associated with a lower risk of neonatal morbidity in very preterm infants. Despite the benefits, the duration of breastfeeding is shorter in very preterm infants than in term infants. This study aimed to investigate how early provision of mother's own milk (MOM) and maternal and infant characteristics are related to breast milk feeding (BMF) between 36 and 40 weeks postmenstrual age (PMA) after very preterm birth. A regional observational study of 138 singleton infants born at < 32 weeks of gestation in Stockholm, Sweden, was conducted. Data were derived from medical charts to investigate the association between early provision of MOM; maternal and infant characteristics; and exclusive, partial, or no BMF at 36 weeks PMA. Moreover, changes in BMF between 36 and 40 weeks PMA were studied. Most infants (80%) received MOM at 36 weeks PMA (55% exclusively, 25% partial). High provision of MOM at postnatal day 7 was associated with exclusive BMF at 36 weeks PMA, odd...

Research paper thumbnail of Maternal overweight and obesity in early pregnancy and risk of infant mortality: a population based cohort study in Sweden

BMJ (Clinical research ed.), 2014

To investigate associations between maternal overweight and obesity and infant mortality outcomes... more To investigate associations between maternal overweight and obesity and infant mortality outcomes, including cause-specific mortality. Population based cohort study. 1,857,822 live single births in Sweden 1992-2010. Associations between maternal body mass index (BMI) in early pregnancy and risks of infant, neonatal, and postneonatal mortality, overall and stratified by gestational length and by causes of infant death. Odds ratios were adjusted for maternal age, parity, smoking, education, height, country of birth, and year of delivery. Infant mortality rates increased from 2.4/1000 among normal weight women (BMI 18.5-24.9) to 5.8/1000 among women with obesity grade 3 (BMI ≥ 40.0). Compared with normal weight, overweight (BMI 25.0-29.9) and obesity grade 1 (BMI 30.0-34.9) were associated with modestly increased risks of infant mortality (adjusted odds ratios 1.25 (95% confidence interval 1.16 to 1.35) and 1.37 (1.22 to 1.53), respectively), and obesity grade 2 (BMI 35.0-39.9) and gra...

Research paper thumbnail of Cause-specific infant mortality in a population-based Swedish study of term and post-term births: the contribution of gestational age and birth weight

BMJ open, 2012

To investigate infant mortality and causes of infant death in relation to gestational age (GA) an... more To investigate infant mortality and causes of infant death in relation to gestational age (GA) and birth weight for GA in non-malformed term and post-term infants. Observational, retrospective nationwide cohort study. Sweden 1983-2006. 2 152 738 singleton non-malformed infants born at 37 gestational weeks or later. Infant, neonatal and postneonatal mortality and causes of infant death. Infant mortality rate was 0.12% (n=2687). Compared with infants born at 40 weeks, risk of infant mortality was increased among early term infants (37 weeks, adjusted OR 1.70, 95% CI 1.43 to 2.02). Compared with infants with normal birth weight for GA, very small for gestational age (SGA; <3rd percentile) infants faced a doubled risk of infant mortality (adjusted OR 2.13, 95% CI 1.80 to 2.53), and corresponding risk was also increased among moderately SGA infants (3rd to <10th percentile; adjusted OR 1.46, 95% CI 1.26 to 1.68). Sudden infant death syndrome (SIDS) was the most common cause of deat...

Research paper thumbnail of Being born too small, too early, or both: does it matter for risk of hypertension in the elderly?

American journal of hypertension, 2008

Low birth weight is an often-reported risk factor for high blood pressure later in life. This stu... more Low birth weight is an often-reported risk factor for high blood pressure later in life. This study investigates the selective contributions of preterm birth and poor fetal growth to later risk of hypertension. A total of 250,000 Swedish birth records from 1925 through 1949 were examined. All subjects born with a gestational duration below 35 weeks and/or a birth weight < or =2,000 g (girls) or < or =2,100 g (boys) were included, as well as an equal number of controls. This yielded a cohort of 6,269 subjects, of which 2,502 were born at <35 weeks of gestation, and 1,226 subjects had a birth weight < or =2,000 g (girls) or < or =2,100 g (boys). The main outcome measure was diagnosis of hypertension in the Swedish Hospital Discharge Register from 1987 through 2006. There were 838 cases of hypertension in the cohort. Birth weight was negatively associated with hypertension (P for trend = 0.0005). This effect was explained by poor fetal growth: when compared with subjects...

Research paper thumbnail of The Importance of Echocardiography and an Individual Approach to Patent Ductus Arteriosus Treatment in Extremely Preterm Infants

Research paper thumbnail of Hypertension, Diabetes and Overweight: Looming Legacies of the Biafran Famine

PLoS ONE, 2010

Background: Sub-Saharan Africa is facing rapidly increasing prevalences of cardiovascular disease... more Background: Sub-Saharan Africa is facing rapidly increasing prevalences of cardiovascular disease, obesity, diabetes and hypertension. Previous and ongoing undernutrition among pregnant women may contribute to this development as suggested by epidemiological studies from high income countries linking undernutrition in fetal life with increased burden of non-communicable diseases in later life. We undertook to study the risks for hypertension, glucose intolerance and overweight forty years after fetal exposure to famine afflicted Biafra during the Nigerian civil war (1967)(1968)(1969)(1970). after (1971-73) the years of famine were included. Blood pressure (BP), random plasma glucose (p-glucose) and anthropometrics, as well as prevalence of hypertension (BP.140/90 mmHg), impaired glucose tolerance (IGT; p-glucose 7.8-11.0 mmol/l), diabetes (DM; p-glucose $11.1 mmol/l), or overweight (BMI.25 kg/m 2 ) were compared between the three groups. Fetal-infant exposure to famine was associated with elevated systolic (+7 mmHg; p,0.001) and diastolic (+5 mmHg; p,0.001) BP, increased p-glucose (+0.3 mmol/L; p,0.05) and waist circumference (+3cm, p,0.001), increased risk of systolic hypertension (adjusted OR 2.87; 95% CI 1.90-4.34), IGT (OR 1.65; 95% CI 1.02-2.69) and overweight (OR 1.41; 95% CI 1.03-1.93) as compared to people born after the famine. Limitations of this study include the lack of birth weight data and the inability to separate effects of fetal and infant famine.

Research paper thumbnail of Aortic wall thickening in utero

Research paper thumbnail of Maternal Obesity and Risk of Preterm Delivery

JAMA, 2013

Importance Preterm birth is a leading cause of infant mortality, morbidity, and longterm disabili... more Importance Preterm birth is a leading cause of infant mortality, morbidity, and longterm disability, and these risks increase with decreasing gestational age. Obesity increases the risk of preterm delivery, but the associations between overweight and obesity and subtypes of preterm delivery are not clear.

Research paper thumbnail of Cerebrovascular and ischemic heart disease in young adults born preterm: a population-based Swedish cohort study

European Journal of Epidemiology, 2014

Preterm birth is associated with overall cardiovascular mortality in young adulthood, but which s... more Preterm birth is associated with overall cardiovascular mortality in young adulthood, but which specific conditions that underlie this association is unknown. We studied mortality and morbidity from cerebrovascular and ischemic heart disease in individuals born preterm. In a nationwide Swedish study, we included 1,306,943 individuals without congenital malformations born between 1983 and 1995, followed from 15 years of age to December 31st, 2010. Of these, 73,489 (5.6 %) were born preterm (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;37 weeks of gestation). Cox proportional hazards regression analysis was used to calculate hazard ratios (HR) with 95 % confidence intervals (CI), after adjusting for maternal characteristics and birth weight for gestational age. Of 955 incident cases of cerebrovascular disease, 58 (6.1 %) occurred in preterm born subjects. The corresponding numbers of ischemic heart disease cases were 180 and 13 (7.2 %), respectively. Birth before 32 weeks was associated with a nearly twofold increased risk of cerebrovascular disease; adjusted HR, (95 % CI) = 1.89 (1.01-3.54) compared to term born individuals, whereas individuals born at 32-36 weeks were not at increased risk. Preterm birth was not associated with later ischemic heart disease; no cases of ischemic heart disease were recorded among those born before 32 weeks and the HR (95 % CI) for those born at 32-36 weeks of gestation was 1.45 (0.81-2.57), compared to term-born individuals. Birth before 32 weeks is associated with increased risk of cerebrovascular disease in young adulthood. Our data suggest that cardiovascular health promotion in follow-up programs after very preterm birth may be beneficial.

Research paper thumbnail of Risk of oesophageal adenocarcinoma among individuals born preterm or small for gestational age

European Journal of Cancer, 2013

Background: Gastroesophageal reflux is a main risk factor for oesophageal adenocarcinoma (EAC). I... more Background: Gastroesophageal reflux is a main risk factor for oesophageal adenocarcinoma (EAC). Infants born preterm or small for gestational age (SGA) regurgitate more than infants born at term, and some data support the hypothesis of an association with oesophagitis, Barrett's oesophagus and EAC. This study aimed to assess the association between risk of EAC and preterm or SGA birth. Methods: In this population-based case-control study, all incident cases of EAC in Sweden between 1st January 1998 and 31st December 2004 with retrievable birth records were eligible as cases. We sampled three matched controls per case from the birth ledger at the same delivery ward as the respective case. Data on gestational age, birth weight and other perinatal exposures were extracted from the original birth records. For comparison, we collected perinatal data for cases of cardia adenocarcinoma and oesophageal squamous cell carcinoma and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: The risk of EAC increased by 13% per week of shorter duration of gestation (OR 1.1, 95% CI 1.0-1.3), while SGA did not influence the risk. No effect of preterm birth or SGA was found on the risk of cardia adenocarcinoma or oesophageal squamous cell carcinoma. Conclusion: Preterm birth, but not SGA, might lead to an increased risk of EAC as an adult.

Research paper thumbnail of Perinatal Risk Factors for Diabetes in Later Life

Research paper thumbnail of Birth Characteristics and Subsequent Risks of Maternal Cardiovascular Disease: Effects of Gestational Age and Fetal Growth

Circulation, 2011

Prior studies showing an inverse relationship between low birth weight in offspring and maternal ... more Prior studies showing an inverse relationship between low birth weight in offspring and maternal risks of cardiovascular diseases (CVD) are limited by lack of information on gestational age and/or insufficient adjustment for confounders. In a nationwide Swedish study, we included information on 923 686 women and their first singleton births between 1983 and 2005. Cox proportional hazards models were used to study associations between gestational length, fetal growth, and maternal incident hospitalization or death from CVD (coronary heart disease, cerebrovascular events, and heart failure). Multivariable adjusted models accounted for birth year, income, education, country of birth, smoking, diabetes mellitus, hypertension, and preeclampsia. The risk of maternal CVD increased with decreasing gestational age whereas the risk increase related to fetal growth appeared to be restricted to very small-for-gestational-age (SGA) infants. Compared with mothers of non-SGA infants born at term, the hazard ratio of CVD ranged from 1.39 (95% confidence interval 1.22-1.58) to 2.57 (95% confidence interval 1.97-3.34) among mothers to moderately and very preterm infants, respectively. There was a significant interaction between preterm birth and fetal growth with respect to mothers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; risk of CVD (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Among mothers to very SGA infants, the hazard ratio of CVD ranged from 1.38 (95% confidence interval 1.15-1.65) to 3.40 (95% confidence interval 2.26-5.11) in mothers to term and very preterm infants, respectively. Delivery of a preterm or SGA infant is associated with later life maternal hospitalization or death from CVD even after accounting for socioeconomic factors, smoking, and pregnancy-related complications.

Research paper thumbnail of Preterm birth and maternal smoking in pregnancy are strong risk factors for aortic narrowing in adolescence

Acta Pdiatrica, 2008

Preterm transition from foetal to neonatal circulation might permanently alter aortic growth and ... more Preterm transition from foetal to neonatal circulation might permanently alter aortic growth and development. To test this hypothesis, we measured aortic dimensions in adolescents born very preterm. Eighty-six healthy 15-year-old subjects were studied; 45 born very preterm at an average gestational age of 28 weeks (birth weight &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1500 g) and 41 controls born at term. Using a pulse-gated Fiesta sequence on a 1.5T MR-scanner, 25 images were collected within the heart cycle at several levels of the descending aorta. End-diastolic cross-sectional areas were semi-automatically calculated using an active contour model. Subjects born preterm had narrower aortic lumen. The difference was 16% in the thoracic and 19% in the abdominal aorta after adjustment for body surface area and gender (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Maternal smoking in pregnancy was also found to be an independent risk factor for aortic narrowing in the offspring (difference 10%-13% throughout the aorta vs. offspring to nonsmoking mothers). Adolescents born preterm had higher systolic and diastolic blood pressures; however, blood pressures did not correlate with aortic size or maternal smoking during pregnancy. Very preterm birth and exposure to maternal smoking in foetal life are independent and strong risk factors for general aortic narrowing 15 years after birth.

Research paper thumbnail of Preterm birth and carotid diameter and stiffness in childhood

Acta Paediatrica, 2008

Low birthweight, either as a result of poor foetal growth or preterm birth, is a risk factor for ... more Low birthweight, either as a result of poor foetal growth or preterm birth, is a risk factor for stroke in adult life. Carotid stiffening, an early marker of atheromatous disease, has been found in low-birthweight children born at term. We hypothesized that carotid artery growth and dynamic properties are permanently affected by preterm birth. Carotid artery stiffness and dimensions in 56 school children, 39 born very preterm (mean gestational age [GA] 29 weeks) and 17 controls born at term, were studied by ultrasonic measurements of the pulsatile movements of the vessel wall. The carotid artery diameter was 6.4 mm both in children born preterm and at term (p=0.99). No difference in carotid stiffness was found. Within the preterm group, no differences could be seen between those born small for gestational age (SGA) or appropriate for gestational age (AGA). Carotid artery elasticity and structure are not altered after preterm birth. The mechanisms behind the increased stroke risk in adults born preterm remain unresolved.

Research paper thumbnail of Maternal Snuff Use and Smoking and the Risk of Oral Cleft Malformations - A Population-Based Cohort Study

PLoS ONE, 2014

Objective: To determine if maternal use of snuff (containing high levels of nicotine, low levels ... more Objective: To determine if maternal use of snuff (containing high levels of nicotine, low levels of nitrosamines and no combustion products) is associated with an increased risk of oral cleft malformations in the infant and whether cessation of snuff use or smoking before the antenatal booking influences the risk.

Research paper thumbnail of Virtual colleagues, virtually colleagues--physicians' use of Twitter: a population-based observational study

BMJ Open, 2013

To investigate potential violations of patient confidentiality or other breaches of medical ethic... more To investigate potential violations of patient confidentiality or other breaches of medical ethics committed by physicians and medical students active on the social networking site Twitter.

Research paper thumbnail of Perinatal Risk Factors for Ischemic Heart Disease Disentangling the Roles of Birth Weight and Preterm Birth

Research paper thumbnail of Perinatal Risk Factors for Diabetes in Later Life

Research paper thumbnail of Early Provision of Mother's Own Milk and Other Predictors of Successful Breast Milk Feeding after Very Preterm Birth: A Regional Observational Study

Journal of human lactation : official journal of International Lactation Consultant Association, Jan 15, 2015

Breast milk is associated with a lower risk of neonatal morbidity in very preterm infants. Despit... more Breast milk is associated with a lower risk of neonatal morbidity in very preterm infants. Despite the benefits, the duration of breastfeeding is shorter in very preterm infants than in term infants. This study aimed to investigate how early provision of mother's own milk (MOM) and maternal and infant characteristics are related to breast milk feeding (BMF) between 36 and 40 weeks postmenstrual age (PMA) after very preterm birth. A regional observational study of 138 singleton infants born at < 32 weeks of gestation in Stockholm, Sweden, was conducted. Data were derived from medical charts to investigate the association between early provision of MOM; maternal and infant characteristics; and exclusive, partial, or no BMF at 36 weeks PMA. Moreover, changes in BMF between 36 and 40 weeks PMA were studied. Most infants (80%) received MOM at 36 weeks PMA (55% exclusively, 25% partial). High provision of MOM at postnatal day 7 was associated with exclusive BMF at 36 weeks PMA, odd...

Research paper thumbnail of Maternal overweight and obesity in early pregnancy and risk of infant mortality: a population based cohort study in Sweden

BMJ (Clinical research ed.), 2014

To investigate associations between maternal overweight and obesity and infant mortality outcomes... more To investigate associations between maternal overweight and obesity and infant mortality outcomes, including cause-specific mortality. Population based cohort study. 1,857,822 live single births in Sweden 1992-2010. Associations between maternal body mass index (BMI) in early pregnancy and risks of infant, neonatal, and postneonatal mortality, overall and stratified by gestational length and by causes of infant death. Odds ratios were adjusted for maternal age, parity, smoking, education, height, country of birth, and year of delivery. Infant mortality rates increased from 2.4/1000 among normal weight women (BMI 18.5-24.9) to 5.8/1000 among women with obesity grade 3 (BMI ≥ 40.0). Compared with normal weight, overweight (BMI 25.0-29.9) and obesity grade 1 (BMI 30.0-34.9) were associated with modestly increased risks of infant mortality (adjusted odds ratios 1.25 (95% confidence interval 1.16 to 1.35) and 1.37 (1.22 to 1.53), respectively), and obesity grade 2 (BMI 35.0-39.9) and gra...

Research paper thumbnail of Cause-specific infant mortality in a population-based Swedish study of term and post-term births: the contribution of gestational age and birth weight

BMJ open, 2012

To investigate infant mortality and causes of infant death in relation to gestational age (GA) an... more To investigate infant mortality and causes of infant death in relation to gestational age (GA) and birth weight for GA in non-malformed term and post-term infants. Observational, retrospective nationwide cohort study. Sweden 1983-2006. 2 152 738 singleton non-malformed infants born at 37 gestational weeks or later. Infant, neonatal and postneonatal mortality and causes of infant death. Infant mortality rate was 0.12% (n=2687). Compared with infants born at 40 weeks, risk of infant mortality was increased among early term infants (37 weeks, adjusted OR 1.70, 95% CI 1.43 to 2.02). Compared with infants with normal birth weight for GA, very small for gestational age (SGA; <3rd percentile) infants faced a doubled risk of infant mortality (adjusted OR 2.13, 95% CI 1.80 to 2.53), and corresponding risk was also increased among moderately SGA infants (3rd to <10th percentile; adjusted OR 1.46, 95% CI 1.26 to 1.68). Sudden infant death syndrome (SIDS) was the most common cause of deat...

Research paper thumbnail of Being born too small, too early, or both: does it matter for risk of hypertension in the elderly?

American journal of hypertension, 2008

Low birth weight is an often-reported risk factor for high blood pressure later in life. This stu... more Low birth weight is an often-reported risk factor for high blood pressure later in life. This study investigates the selective contributions of preterm birth and poor fetal growth to later risk of hypertension. A total of 250,000 Swedish birth records from 1925 through 1949 were examined. All subjects born with a gestational duration below 35 weeks and/or a birth weight < or =2,000 g (girls) or < or =2,100 g (boys) were included, as well as an equal number of controls. This yielded a cohort of 6,269 subjects, of which 2,502 were born at <35 weeks of gestation, and 1,226 subjects had a birth weight < or =2,000 g (girls) or < or =2,100 g (boys). The main outcome measure was diagnosis of hypertension in the Swedish Hospital Discharge Register from 1987 through 2006. There were 838 cases of hypertension in the cohort. Birth weight was negatively associated with hypertension (P for trend = 0.0005). This effect was explained by poor fetal growth: when compared with subjects...

Research paper thumbnail of The Importance of Echocardiography and an Individual Approach to Patent Ductus Arteriosus Treatment in Extremely Preterm Infants

Research paper thumbnail of Hypertension, Diabetes and Overweight: Looming Legacies of the Biafran Famine

PLoS ONE, 2010

Background: Sub-Saharan Africa is facing rapidly increasing prevalences of cardiovascular disease... more Background: Sub-Saharan Africa is facing rapidly increasing prevalences of cardiovascular disease, obesity, diabetes and hypertension. Previous and ongoing undernutrition among pregnant women may contribute to this development as suggested by epidemiological studies from high income countries linking undernutrition in fetal life with increased burden of non-communicable diseases in later life. We undertook to study the risks for hypertension, glucose intolerance and overweight forty years after fetal exposure to famine afflicted Biafra during the Nigerian civil war (1967)(1968)(1969)(1970). after (1971-73) the years of famine were included. Blood pressure (BP), random plasma glucose (p-glucose) and anthropometrics, as well as prevalence of hypertension (BP.140/90 mmHg), impaired glucose tolerance (IGT; p-glucose 7.8-11.0 mmol/l), diabetes (DM; p-glucose $11.1 mmol/l), or overweight (BMI.25 kg/m 2 ) were compared between the three groups. Fetal-infant exposure to famine was associated with elevated systolic (+7 mmHg; p,0.001) and diastolic (+5 mmHg; p,0.001) BP, increased p-glucose (+0.3 mmol/L; p,0.05) and waist circumference (+3cm, p,0.001), increased risk of systolic hypertension (adjusted OR 2.87; 95% CI 1.90-4.34), IGT (OR 1.65; 95% CI 1.02-2.69) and overweight (OR 1.41; 95% CI 1.03-1.93) as compared to people born after the famine. Limitations of this study include the lack of birth weight data and the inability to separate effects of fetal and infant famine.

Research paper thumbnail of Aortic wall thickening in utero

Research paper thumbnail of Maternal Obesity and Risk of Preterm Delivery

JAMA, 2013

Importance Preterm birth is a leading cause of infant mortality, morbidity, and longterm disabili... more Importance Preterm birth is a leading cause of infant mortality, morbidity, and longterm disability, and these risks increase with decreasing gestational age. Obesity increases the risk of preterm delivery, but the associations between overweight and obesity and subtypes of preterm delivery are not clear.

Research paper thumbnail of Cerebrovascular and ischemic heart disease in young adults born preterm: a population-based Swedish cohort study

European Journal of Epidemiology, 2014

Preterm birth is associated with overall cardiovascular mortality in young adulthood, but which s... more Preterm birth is associated with overall cardiovascular mortality in young adulthood, but which specific conditions that underlie this association is unknown. We studied mortality and morbidity from cerebrovascular and ischemic heart disease in individuals born preterm. In a nationwide Swedish study, we included 1,306,943 individuals without congenital malformations born between 1983 and 1995, followed from 15 years of age to December 31st, 2010. Of these, 73,489 (5.6 %) were born preterm (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;37 weeks of gestation). Cox proportional hazards regression analysis was used to calculate hazard ratios (HR) with 95 % confidence intervals (CI), after adjusting for maternal characteristics and birth weight for gestational age. Of 955 incident cases of cerebrovascular disease, 58 (6.1 %) occurred in preterm born subjects. The corresponding numbers of ischemic heart disease cases were 180 and 13 (7.2 %), respectively. Birth before 32 weeks was associated with a nearly twofold increased risk of cerebrovascular disease; adjusted HR, (95 % CI) = 1.89 (1.01-3.54) compared to term born individuals, whereas individuals born at 32-36 weeks were not at increased risk. Preterm birth was not associated with later ischemic heart disease; no cases of ischemic heart disease were recorded among those born before 32 weeks and the HR (95 % CI) for those born at 32-36 weeks of gestation was 1.45 (0.81-2.57), compared to term-born individuals. Birth before 32 weeks is associated with increased risk of cerebrovascular disease in young adulthood. Our data suggest that cardiovascular health promotion in follow-up programs after very preterm birth may be beneficial.

Research paper thumbnail of Risk of oesophageal adenocarcinoma among individuals born preterm or small for gestational age

European Journal of Cancer, 2013

Background: Gastroesophageal reflux is a main risk factor for oesophageal adenocarcinoma (EAC). I... more Background: Gastroesophageal reflux is a main risk factor for oesophageal adenocarcinoma (EAC). Infants born preterm or small for gestational age (SGA) regurgitate more than infants born at term, and some data support the hypothesis of an association with oesophagitis, Barrett's oesophagus and EAC. This study aimed to assess the association between risk of EAC and preterm or SGA birth. Methods: In this population-based case-control study, all incident cases of EAC in Sweden between 1st January 1998 and 31st December 2004 with retrievable birth records were eligible as cases. We sampled three matched controls per case from the birth ledger at the same delivery ward as the respective case. Data on gestational age, birth weight and other perinatal exposures were extracted from the original birth records. For comparison, we collected perinatal data for cases of cardia adenocarcinoma and oesophageal squamous cell carcinoma and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: The risk of EAC increased by 13% per week of shorter duration of gestation (OR 1.1, 95% CI 1.0-1.3), while SGA did not influence the risk. No effect of preterm birth or SGA was found on the risk of cardia adenocarcinoma or oesophageal squamous cell carcinoma. Conclusion: Preterm birth, but not SGA, might lead to an increased risk of EAC as an adult.

Research paper thumbnail of Perinatal Risk Factors for Diabetes in Later Life

Research paper thumbnail of Birth Characteristics and Subsequent Risks of Maternal Cardiovascular Disease: Effects of Gestational Age and Fetal Growth

Circulation, 2011

Prior studies showing an inverse relationship between low birth weight in offspring and maternal ... more Prior studies showing an inverse relationship between low birth weight in offspring and maternal risks of cardiovascular diseases (CVD) are limited by lack of information on gestational age and/or insufficient adjustment for confounders. In a nationwide Swedish study, we included information on 923 686 women and their first singleton births between 1983 and 2005. Cox proportional hazards models were used to study associations between gestational length, fetal growth, and maternal incident hospitalization or death from CVD (coronary heart disease, cerebrovascular events, and heart failure). Multivariable adjusted models accounted for birth year, income, education, country of birth, smoking, diabetes mellitus, hypertension, and preeclampsia. The risk of maternal CVD increased with decreasing gestational age whereas the risk increase related to fetal growth appeared to be restricted to very small-for-gestational-age (SGA) infants. Compared with mothers of non-SGA infants born at term, the hazard ratio of CVD ranged from 1.39 (95% confidence interval 1.22-1.58) to 2.57 (95% confidence interval 1.97-3.34) among mothers to moderately and very preterm infants, respectively. There was a significant interaction between preterm birth and fetal growth with respect to mothers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; risk of CVD (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Among mothers to very SGA infants, the hazard ratio of CVD ranged from 1.38 (95% confidence interval 1.15-1.65) to 3.40 (95% confidence interval 2.26-5.11) in mothers to term and very preterm infants, respectively. Delivery of a preterm or SGA infant is associated with later life maternal hospitalization or death from CVD even after accounting for socioeconomic factors, smoking, and pregnancy-related complications.

Research paper thumbnail of Preterm birth and maternal smoking in pregnancy are strong risk factors for aortic narrowing in adolescence

Acta Pdiatrica, 2008

Preterm transition from foetal to neonatal circulation might permanently alter aortic growth and ... more Preterm transition from foetal to neonatal circulation might permanently alter aortic growth and development. To test this hypothesis, we measured aortic dimensions in adolescents born very preterm. Eighty-six healthy 15-year-old subjects were studied; 45 born very preterm at an average gestational age of 28 weeks (birth weight &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1500 g) and 41 controls born at term. Using a pulse-gated Fiesta sequence on a 1.5T MR-scanner, 25 images were collected within the heart cycle at several levels of the descending aorta. End-diastolic cross-sectional areas were semi-automatically calculated using an active contour model. Subjects born preterm had narrower aortic lumen. The difference was 16% in the thoracic and 19% in the abdominal aorta after adjustment for body surface area and gender (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Maternal smoking in pregnancy was also found to be an independent risk factor for aortic narrowing in the offspring (difference 10%-13% throughout the aorta vs. offspring to nonsmoking mothers). Adolescents born preterm had higher systolic and diastolic blood pressures; however, blood pressures did not correlate with aortic size or maternal smoking during pregnancy. Very preterm birth and exposure to maternal smoking in foetal life are independent and strong risk factors for general aortic narrowing 15 years after birth.

Research paper thumbnail of Preterm birth and carotid diameter and stiffness in childhood

Acta Paediatrica, 2008

Low birthweight, either as a result of poor foetal growth or preterm birth, is a risk factor for ... more Low birthweight, either as a result of poor foetal growth or preterm birth, is a risk factor for stroke in adult life. Carotid stiffening, an early marker of atheromatous disease, has been found in low-birthweight children born at term. We hypothesized that carotid artery growth and dynamic properties are permanently affected by preterm birth. Carotid artery stiffness and dimensions in 56 school children, 39 born very preterm (mean gestational age [GA] 29 weeks) and 17 controls born at term, were studied by ultrasonic measurements of the pulsatile movements of the vessel wall. The carotid artery diameter was 6.4 mm both in children born preterm and at term (p=0.99). No difference in carotid stiffness was found. Within the preterm group, no differences could be seen between those born small for gestational age (SGA) or appropriate for gestational age (AGA). Carotid artery elasticity and structure are not altered after preterm birth. The mechanisms behind the increased stroke risk in adults born preterm remain unresolved.

Research paper thumbnail of Maternal Snuff Use and Smoking and the Risk of Oral Cleft Malformations - A Population-Based Cohort Study

PLoS ONE, 2014

Objective: To determine if maternal use of snuff (containing high levels of nicotine, low levels ... more Objective: To determine if maternal use of snuff (containing high levels of nicotine, low levels of nitrosamines and no combustion products) is associated with an increased risk of oral cleft malformations in the infant and whether cessation of snuff use or smoking before the antenatal booking influences the risk.