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Antepartum risk factors for moderate to severe neonatal hypoxic ischemic encephalopathy: a Swedish national cohort study.

https://arctichealth.org/en/permalink/ahliterature295711
Source
Acta Obstet Gynecol Scand. 2018 May; 97(5):615-623
Publication Type
Journal Article
Date
May-2018
Author
Lena Liljestrom
Anna-Karin Wikstrom
Johan Agren
Maria Jonsson
Author Affiliation
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Source
Acta Obstet Gynecol Scand. 2018 May; 97(5):615-623
Date
May-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Body Height
Body mass index
Female
Humans
Hypoxia-Ischemia, Brain - diagnosis - epidemiology - etiology
Infant, Newborn
Logistic Models
Male
Overweight - complications
Pregnancy
Prenatal Exposure Delayed Effects - diagnosis - epidemiology - etiology
Registries
Risk factors
Severity of Illness Index
Sweden - epidemiology
Abstract
Our aim was to identify antepartum risk factors for neonatal hypoxic ischemic encephalopathy, with a focus on maternal body mass index and height.
National population-based cohort study of 692 428 live-born infants =36 gestational weeks in Sweden, 2009-2015. Data from the Swedish Medical Birth Register and the Swedish Neonatal Quality Register were linked. Short maternal stature was defined as =155 cm, and overweight as body mass index =25 kg/m2 . Therapeutic hypothermia served as surrogate marker of moderate to severe hypoxic ischemic encephalopathy. Associations between maternal and infant characteristics and hypoxic ischemic encephalopathy were calculated with logistic regression analyses, and risks were presented as odds ratios with 95% confidence intervals.
Moderate to severe hypoxic ischemic encephalopathy occurred in 0.67/1000 infants. Nulliparity, previous cesarean delivery, short stature, overweight, gestational age, occiput posterior presentation and birthweight were all independently associated with hypoxic ischemic encephalopathy. The risk of hypoxic ischemic encephalopathy increased with decreasing maternal height and increasing body mass index. Compared with non-short women (=156 cm) with normal weight (body mass index
PubMed ID
29450878 View in PubMed
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Comparison of strain typing results for Clostridium difficile isolates from North America.

https://arctichealth.org/en/permalink/ahliterature136324
Source
J Clin Microbiol. 2011 May;49(5):1831-7
Publication Type
Article
Date
May-2011
Author
Fred C Tenover
Thomas Akerlund
Dale N Gerding
Richard V Goering
Therése Boström
Anna-Maria Jonsson
Edith Wong
Alan T Wortman
David H Persing
Author Affiliation
Cepheid, Sunnyvale, California 94089, USA. fred.tenover@cepheid.com
Source
J Clin Microbiol. 2011 May;49(5):1831-7
Date
May-2011
Language
English
Publication Type
Article
Keywords
Bacterial Typing Techniques - methods
Canada
Clostridium Infections - microbiology
Clostridium difficile - classification - genetics - isolation & purification
Cluster analysis
Electrophoresis, Gel, Pulsed-Field
Genotype
Humans
Molecular Epidemiology - methods
Molecular Typing - methods
Polymorphism, Restriction Fragment Length
Ribotyping
United States
Abstract
Accurate strain typing is critical for understanding the changing epidemiology of Clostridium difficile infections. We typed 350 isolates of toxigenic C. difficile from 2008 to 2009 from seven laboratories in the United States and Canada. Typing was performed by PCR-ribotyping, pulsed-field gel electrophoresis (PFGE), and restriction endonuclease analysis (REA) of whole-cell DNA. The Cepheid Xpert C. difficile test for presumptive identification of 027/NAP1/BI isolates was also tested directly on original stool samples. Of 350 isolates, 244 (70%) were known PCR ribotypes, 224 (68%) were 1 of 8 common REA groups, and 187 (54%) were known PFGE types. Eighty-four isolates typed as 027, NAP1, and BI, and 83 of these were identified as presumptive 027/NAP1/BI by Xpert C. difficile. Eight additional isolates were called presumptive 027/NAP1/BI by Xpert C. difficile, of which three were ribotype 027. Five PCR ribotypes contained multiple REA groups, and three North American pulsed-field (NAP) profiles contained both multiple REA groups and PCR ribotypes. There was modest concordance of results among the three methods for C. difficile strains, including the J strain (ribotype 001 and PFGE NAP2), the toxin A-negative 017 strain (PFGE NAP9 and REA type CF), the 078 animal strain (PFGE NAP7 and REA type BK), and type 106 (PFGE NAP11 and REA type DH). PCR-ribotyping, REA, and PFGE provide different but overlapping patterns of strain clustering. Unlike the other methods, the Xpert C. difficile 027/NAP1/BI assay gave results directly from stool specimens, required only 45 min to complete, but was limited to detection of a single strain type.
Notes
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PubMed ID
21389155 View in PubMed
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Diabetes duration and health-related quality of life in individuals with onset of diabetes in the age group 15-34 years - a Swedish population-based study using EQ-5D.

https://arctichealth.org/en/permalink/ahliterature264171
Source
BMC Public Health. 2013;13:377
Publication Type
Article
Date
2013
Author
Vibeke Sparring
Lennarth Nyström
Rolf Wahlström
Pia Maria Jonsson
Jan Ostman
Kristina Burström
Source
BMC Public Health. 2013;13:377
Date
2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - epidemiology - etiology - prevention & control
Female
Health Status Indicators
Humans
Male
Middle Aged
Quality of Life
Questionnaires
Regression Analysis
Social Class
Sweden - epidemiology
Abstract
Diabetes with onset in younger ages affects both length of life and health status due to debilitating and life-threatening long-term complications. In addition, episodes and fear of hypoglycaemia and of long-term consequences may have a substantial impact on health status. This study aims to describe and analyse health-related quality of life (HRQoL) in individuals with onset of diabetes at the age of 15-34 years and with a disease duration of 1, 8, 15 and 24 years compared with control individuals matched for age, sex and county of residence.
Cross-sectional study of 839 individuals with diabetes and 1564 control individuals. Data on socioeconomic status and HRQoL using EQ-5D were collected by a postal questionnaire. Insulin treatment was self-reported by 94% of the patients, the majority most likely being type 1.
Individuals with diabetes reported lower HRQoL, with a significantly lower mean EQ VAS score in all cohorts of disease duration compared with control individuals for both men and women, and with a significantly lower EQ-5Dindex for women, but not for men, 15 years (0.76, p = 0.022) and 24 years (0.77, p = 0.016) after diagnosis compared with corresponding control individuals. Newly diagnosed individuals with diabetes reported significantly more problems compared with the control individuals in the dimension usual activities (women: 13.2% vs. 4.0%, p = 0.048; men: 11.4% vs. 4.1%, p = 0.033). In the other dimensions, differences between individuals with diabetes and control individuals were found 15 and 24 years after diagnosis: for women in the dimensions mobility, self-care, usual activities and pain/discomfort and for men in the dimension mobility. Multivariable regression analysis showed that diabetes duration, being a woman, having a lower education and not being married or cohabiting had a negative impact on HRQoL.
Our study confirms the negative impact of diabetes on HRQoL and that the difference to control individuals increased by disease duration for women with diabetes. The small difference one year after diagnosis could imply a good management of diabetes care and a relatively quick adaptation. Our results also indicate that gender differences still exist in Sweden, despite modern diabetes treatment and management in Sweden.
Notes
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PubMed ID
23607813 View in PubMed
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Evaluation of the discrepancy between pH and lactate in combined fetal scalp blood sampling.

https://arctichealth.org/en/permalink/ahliterature133424
Source
Acta Obstet Gynecol Scand. 2011 Oct;90(10):1088-93
Publication Type
Article
Date
Oct-2011
Author
Lena Liljeström
Anna-Karin Wikström
Ulf Hanson
Helena Akerud
Maria Jonsson
Author Affiliation
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. lena.liljestrom@kbh.uu.se
Source
Acta Obstet Gynecol Scand. 2011 Oct;90(10):1088-93
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Cohort Studies
Female
Fetal Blood - chemistry
Fetal Distress - physiopathology
Fetal Monitoring - methods
Gestational Age
Hospitals, University
Humans
Hydrogen-Ion Concentration
Labor, Obstetric
Lactates - blood - metabolism
Predictive value of tests
Pregnancy
Pregnancy outcome
Prenatal Care - methods
Risk assessment
Scalp - blood supply - metabolism
Sensitivity and specificity
Statistics, nonparametric
Sweden
Abstract
To evaluate the rate of discrepancy between pH and lactate values in fetal blood sampling (FBS). To evaluate differences in obstetric management in response to combined tests (pH and lactate) and single tests (pH or lactate).
Descriptive study.
Uppsala University Hospital, Sweden.
Labors monitored by FBS during one year (n=241).
Discrepancy in the combined tests was defined as a test having one abnormal and one normal value. Abnormal pH was defined as 7.24 or lower and abnormal lactate as 4.2 or higher. The results were categorized according to whether the test was normal or abnormal and according to whether it was a combined or single analysis.
Discrepancy between pH and lactate values in combined tests. Frequency of operative delivery for fetal distress (ODFD). Time interval from the last FBS to ODFD.
In the combined tests with abnormality, a discrepancy between pH and lactate values occurred in 55%. The mean time interval from the last FBS to ODFD was longer in combined tests with one abnormal compared with two abnormal test results, 75 vs. 37 minutes (p
Notes
Comment In: Acta Obstet Gynecol Scand. 2012 Jul;91(7):879-8022168907
PubMed ID
21707554 View in PubMed
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Experience of fetal scalp blood sampling during labor.

https://arctichealth.org/en/permalink/ahliterature106755
Source
Acta Obstet Gynecol Scand. 2014 Jan;93(1):113-7
Publication Type
Article
Date
Jan-2014
Author
Lena Liljeström
Anna-Karin Wikström
Alkistis Skalkidou
Helena Akerud
Maria Jonsson
Author Affiliation
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Source
Acta Obstet Gynecol Scand. 2014 Jan;93(1):113-7
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Adult
Blood Specimen Collection - adverse effects - methods
Female
Fetal Blood
Fetal Monitoring - adverse effects - methods
Humans
Hydrogen-Ion Concentration
Labor, Obstetric
Pain - etiology
Pain Measurement
Pregnancy
Questionnaires
Scalp - blood supply
Sweden
Abstract
Fetal scalp blood sampling (FBS) is often claimed to be painful for women in labor and difficult for obstetricians to perform. Our aim was to assess women's experience of pain during FBS and obstetricians' experience of difficulty in performing the test. At a tertiary center in Sweden, a questionnaire with answers on a 10-point scale was completed by 51 women and the obstetricians performing the test. Women's experience of pain had a median of 3.5. FBS was well tolerated in women who had epidural analgesia but might be associated with pain in women without. Higher maternal body mass index and less cervical dilation were associated with higher pain ratings. Obstetricians did not generally experience scalp sampling as difficult to perform (median score 3.0). However, the sampling procedure can be more complicated in situations with higher maternal body mass index, less cervical dilation, and a higher station of the fetal head.
PubMed ID
24116986 View in PubMed
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Foreign-born women's lifestyle and health before and during early pregnancy in Sweden.

https://arctichealth.org/en/permalink/ahliterature307397
Source
Eur J Contracept Reprod Health Care. 2020 Feb; 25(1):20-27
Publication Type
Comparative Study
Journal Article
Date
Feb-2020
Author
Jenny Niemeyer Hultstrand
Tanja Tydén
Mats Målqvist
Maria Ekstrand Ragnar
Margareta Larsson
Maria Jonsson
Author Affiliation
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Source
Eur J Contracept Reprod Health Care. 2020 Feb; 25(1):20-27
Date
Feb-2020
Language
English
Publication Type
Comparative Study
Journal Article
Keywords
Adult
Cross-Cultural Comparison
Europe - ethnology
Family Planning Services - methods - statistics & numerical data
Female
Humans
Life Style - ethnology
Preconception Care - methods - statistics & numerical data
Pregnancy
Pregnant Women - ethnology - psychology
Surveys and Questionnaires
Sweden - ethnology
Women's Health - ethnology
Abstract
Objectives: The aims of the study were to investigate foreign-born women's lifestyle and health before and during early pregnancy and compare them with those of Nordic-born women.Methods: Women recruited at antenatal clinics in Sweden answered a questionnaire in Swedish, English or Arabic or by telephone interview with an interpreter. Questions covered pregnancy planning and periconceptional lifestyle and health. The responses of women born in or outside Europe were compared with those of Nordic-born women. The impact of religiousness and integration on periconceptional lifestyle and health was also investigated.Results: Twelve percent of participants (N?=?3389) were foreign-born (n?=?414). Compared with Nordic women, European and non-European women consumed less alcohol before conception (respectively, adjusted odds ratio [aOR] 0.38; 95% confidence interval [CI] 0.24, 0.58 and aOR 0.14; 95% CI 0.10, 0.19) and during early pregnancy (respectively, aOR 0.61; 95% CI 0.40, 0.91 and aOR 0.20; 95% CI 0.14, 0.29). Non-European women used less tobacco and were less physically active, but body mass index (BMI) did not differ between groups. Self-perceived health, stress and anxiety during early pregnancy did not differ, but non-European women more often had depressive symptoms (aOR 1.67; 95% CI 1.12, 2.51). Non-European women's healthy lifestyle was associated with religiousness but not with the level of integration.Conclusions: Non-European women were overall less likely to engage in harmful lifestyle habits before and during early pregnancy but were more likely to suffer from depressive symptoms in comparison with Nordic women.
PubMed ID
31914332 View in PubMed
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Gender equity in health care in Sweden-Minor improvements since the 1990s.

https://arctichealth.org/en/permalink/ahliterature51806
Source
Health Policy. 2005 Sep 7;
Publication Type
Article
Date
Sep-7-2005
Author
Pia Maria Jonsson
Ingrid Schmidt
Vibeke Sparring
Göran Tomson
Author Affiliation
Medical Management Centre, Karolinska Institute, Berzelius väg 3, SE-171 77 Stockholm, Sweden.
Source
Health Policy. 2005 Sep 7;
Date
Sep-7-2005
Language
English
Publication Type
Article
Abstract
A report by the Swedish National Committee on Gender Disparities in Patient Care (1996) identified many shortcomings in the ability of the health sector to gear patient management and treatment to the specific needs of men and women. To promote gender equity in health care, the Committee presented several proposals relating to research, education, monitoring, and evaluation of health services and the responsibilities of health authorities. In 2002, the Swedish Government authorised the National Board of Health and Welfare to review and analyse gender equity trends in health care. Data from, e.g. the national quality registers, epidemiological health data registers, population surveys, and Patient Trust Boards were compiled to identify gender disparities in the quality and accessibility of health services. The curricula of medical universities and the policies of major research funds were reviewed, as were developments in major fields of health research. The National Board found that many of the gender disparities identified in the 1990s still exist, e.g. access to advanced evidence-based technologies such as coronary interventions. As previously, women account for around 60%, and men for 40%, of complaints, e.g. to the Patients' Advisory Committees. Many of the proposals of the National Committee have not been fully implemented by the national authorities or the county councils. We conclude that promoting gender equity in health care is an important but difficult task for health authorities. To make health services more gender sensitive a combination of strategies, including enforcement by guidelines and regulations, may be needed.
PubMed ID
16154225 View in PubMed
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Induction of labour at 41 weeks versus expectant management and induction of labour at 42 weeks (SWEdish Post-term Induction Study, SWEPIS): multicentre, open label, randomised, superiority trial.

https://arctichealth.org/en/permalink/ahliterature308083
Source
BMJ. 2019 11 20; 367:l6131
Publication Type
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Date
11-20-2019
Author
Ulla-Britt Wennerholm
Sissel Saltvedt
Anna Wessberg
Mårten Alkmark
Christina Bergh
Sophia Brismar Wendel
Helena Fadl
Maria Jonsson
Lars Ladfors
Verena Sengpiel
Jan Wesström
Göran Wennergren
Anna-Karin Wikström
Helen Elden
Olof Stephansson
Henrik Hagberg
Author Affiliation
Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital, 416 85 Gothenburg, Sweden ulla-britt.wennerholm@vgregion.se.
Source
BMJ. 2019 11 20; 367:l6131
Date
11-20-2019
Language
English
Publication Type
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Keywords
Adult
Cesarean Section - statistics & numerical data
Female
Gestational Age
Humans
Infant
Infant mortality
Infant, Newborn
Infant, Newborn, Diseases - epidemiology - etiology
Intention to Treat Analysis
Labor, Induced - adverse effects - methods - statistics & numerical data
Pregnancy
Pregnancy Outcome - epidemiology
Stillbirth - epidemiology
Sweden - epidemiology
Term Birth
Watchful Waiting - statistics & numerical data
Abstract
To evaluate if induction of labour at 41 weeks improves perinatal and maternal outcomes in women with a low risk pregnancy compared with expectant management and induction of labour at 42 weeks.
Multicentre, open label, randomised controlled superiority trial.
14 hospitals in Sweden, 2016-18.
2760 women with a low risk uncomplicated singleton pregnancy randomised (1:1) by the Swedish Pregnancy Register. 1381 women were assigned to the induction group and 1379 were assigned to the expectant management group.
Induction of labour at 41 weeks and expectant management and induction of labour at 42 weeks.
The primary outcome was a composite perinatal outcome including one or more of stillbirth, neonatal mortality, Apgar score less than 7 at five minutes, pH less than 7.00 or metabolic acidosis (pH 12 mmol/L) in the umbilical artery, hypoxic ischaemic encephalopathy, intracranial haemorrhage, convulsions, meconium aspiration syndrome, mechanical ventilation within 72 hours, or obstetric brachial plexus injury. Primary analysis was by intention to treat.
The study was stopped early owing to a significantly higher rate of perinatal mortality in the expectant management group. The composite primary perinatal outcome did not differ between the groups: 2.4% (33/1381) in the induction group and 2.2% (31/1379) in the expectant management group (relative risk 1.06, 95% confidence interval 0.65 to 1.73; P=0.90). No perinatal deaths occurred in the induction group but six (five stillbirths and one early neonatal death) occurred in the expectant management group (P=0.03). The proportion of caesarean delivery, instrumental vaginal delivery, or any major maternal morbidity did not differ between the groups.
This study comparing induction of labour at 41 weeks with expectant management and induction at 42 weeks does not show any significant difference in the primary composite adverse perinatal outcome. However, a reduction of the secondary outcome perinatal mortality is observed without increasing adverse maternal outcomes. Although these results should be interpreted cautiously, induction of labour ought to be offered to women no later than at 41 weeks and could be one (of few) interventions that reduces the rate of stillbirths.
Current Controlled Trials ISRCTN26113652.
PubMed ID
31748223 View in PubMed
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Induction of twin pregnancy and the risk of caesarean delivery: a cohort study.

https://arctichealth.org/en/permalink/ahliterature270454
Source
BMC Pregnancy Childbirth. 2015;15:136
Publication Type
Article
Date
2015
Author
Maria Jonsson
Source
BMC Pregnancy Childbirth. 2015;15:136
Date
2015
Language
English
Publication Type
Article
Keywords
Adult
Amnion - surgery
Birth weight
Cervical Ripening
Cesarean Section - statistics & numerical data
Female
Gestational Age
Humans
Infant, Newborn
Labor, Induced - adverse effects - methods
Logistic Models
Maternal Age
Odds Ratio
Oxytocics - therapeutic use
Oxytocin - therapeutic use
Pregnancy
Pregnancy, Twin - statistics & numerical data
Retrospective Studies
Risk factors
Sweden
Abstract
Complications are common in twin pregnancies and induction of labour is often indicated. Most methods for induction are used but data on risks related to induction methods are sparse. The aim of this study was to investigate the association between induction of labour and caesarean delivery in twin pregnancies, and to assess the influence of induction method.
Cohort study of twin pregnancies = 34 weeks, planned for vaginal delivery, from two University Hospitals in Sweden. Data were collected from medical records during the periods 1994 (Örebro) and 2004 (Uppsala) to 2013. During the study period there were 78,180 live born births and 1,282 were twin births. Women with previous caesarean section were excluded. Induction methods were categorized into amniotomy, oxytocin and cervical ripening (intra cervical Foley catheter or prostaglandin). Adjusted odds ratios (AOR) with 95 % confidence interval (CI) for caesarean section were calculated by logistic regression and were adjusted for parity, maternal age, gestational length, complications to the pregnancy, infant birth weight and year of birth. Spontaneous labour onsets were used as the reference group. The main outcome measure was caesarean section.
In 462 twin pregnancies, 220 (48 %) had induction of labour and 242 (52 %) a spontaneous labour onset. Amniotomy was performed in 149 (68 %) of these inductions, oxytocin was administered in 11 (5 %) and cervical ripening was used in 60 (27 %). The rate of caesarean sections was 21 % in induced and 12 % in spontaneous labours (p 0.01). The absolute risk of caesarean section following induction was: 15 % with amniotomy; 36 % with oxytocin and 37 % with Foley/prostaglandin. Induction of labour increased the risk of caesarean section by 90 % compared with spontaneous labour onset (AOR 1.9, 95 % CI 1.1-3.5) and, when cervical ripening was used, the risk increased more than two fold (AOR 2.5, 95 % CI 1.2-5.3).
Induction of labour in twin pregnancies increases the risk of caesarean section compared with spontaneous labour onset, especially if Foley catheter or prostaglandins are required. However, approximately 80 % of induced labours are delivered vaginally.
Notes
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PubMed ID
26077416 View in PubMed
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Seizures in newborn infants without hypoxic ischemic encephalopathy - antenatal and labor-related risk factors: a case-control study.

https://arctichealth.org/en/permalink/ahliterature309713
Source
J Matern Fetal Neonatal Med. 2020 Mar; 33(5):799-805
Publication Type
Journal Article
Multicenter Study
Date
Mar-2020
Author
Olle Malmqvist
Andreas Ohlin
Johan Ågren
Maria Jonsson
Author Affiliation
Department of Pediatrics, Faculty of Medicine and Health, Örebro Universitet, Örebro, Sweden.
Source
J Matern Fetal Neonatal Med. 2020 Mar; 33(5):799-805
Date
Mar-2020
Language
English
Publication Type
Journal Article
Multicenter Study
Keywords
Case-Control Studies
Female
Humans
Infant, Newborn
Labor, Induced
Male
Premature Birth
Risk factors
Seizures - epidemiology
Sweden - epidemiology
Abstract
Objective: To identify antepartum and intrapartum risk factors for neonatal seizures in the absence of hypoxic ischemic encephalopathy (HIE).Methods: Population-based case-control study. Of 98 484 births, 40 newborns at 34 gestational weeks or later had seizures within the first 7 days of life. Cases (n?=?40) and controls (n?=?160) were retrieved from the University hospitals of Örebro for 1994-2013 and Uppsala for 2003-2013. Demographics and characteristics of pregnancy, labor, delivery, and neonatal data were analyzed. Crude odds ratio (OR) and adjusted odds ratios (AOR) with 95% confidence intervals (CIs) for antenatal and intrapartum factors were calculated using logistic regression analysis. Main outcome measure was neonatal seizures within the first 7 days of life.Results: The incidence of neonatal seizures without HIE was 0.41/1000 live births. Antenatal risk factors for neonatal seizures were as follows: short maternal stature (AOR: 5.4; 1.8-16.5); previous caesarean section (AOR: 4.8; 1.5-15.0); and assisted fertilization (AOR: 6.8; 1.3-35.2). Intrapartum risk factors were as follows: induction of labor (AOR: 5.7; 1.8-17.7); preterm birth (AOR: 13.5; 3.7-48.9); and head circumference >37?cm (AOR: 6.9; 1.4-34.8).Conclusions: Preterm birth was the strongest risk factor for neonatal seizures in the absence of HIE. The results also indicate that feto-pelvic disproportion is associated with the occurrence of seizures.Rationale: Antepartum and intrapartum risk factors for newborn seizures in the absence of HIE were investigated in a case-control study. Out of 98 484 births at 34 gestational weeks or more, 40 newborns had seizures without HIE. All had a normal Apgar score although they later presented with seizures. Preterm birth was the strongest risk factor (OR: 13.5; 95% CI: 3.7-48.9). Our results also indicate that feto-pelvic disproportion is of importance. Furthermore, a history of prior caesarean was associated with seizures. This is the first study to assess obstetric risk factors for newborn seizures separate from those with seizures and concomitant HIE. The distinction is of importance due to different etiologies, treatments, and preventive strategies.
PubMed ID
30373414 View in PubMed
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